Personalized Antiplatelet Therapy in CAD Patients

Study Overview
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Brief Summary
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This study is a prospective, no-randomized, single-center study performed on 15000 consecutive coronary artery patients from Dec. 2016 to Oct. 2021. All these patients were detected CYP2C19 genotype. The antiplatelet treatment was recorded according to the therapy actually adopted by the patients.

Official Title
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Personalized Antiplatelet Therapy According to CYP2C19 Genotype in Coronary Artery Disease: A Real World Study

Conditions
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Coronary Artery Disease

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1.Aged >18 years old; 2. Coronary angiography confirmed that there was at least one coronary artery stenosis >70%; or the degree of stenosis of the left main artery stenosis >50%; 3. At least one clinical phenotype of coronary heart disease is present: stable angina or acute coronary syndrome 4.To be able to sign informed consent. Exclusion Criteria: Combined with severe valvular heart disease; Combined with severe congenital heart disease; Combined hyperthyroidism, anemia and other high-powered heart disease; 4. With pulmonary heart disease; 5. With hypertrophic obstructive cardiomyopathy; 6. Severe hypotension (SBP <90mmHg or DBP <60mmHg at enrollment); 7. Liver dysfunction (defined as ALT or total bilirubin is greater than the normal upper limit of 3 times); 8. Renal insufficiency (defined as serum creatinine greater than 1.5 times the normal upper limit); 9. High-risk bleeding patients, such as thrombocytopenia, blood diseases and other diseases; 10. active peptic ulcer and skin ulcers; 11. A patient who is allergic to clopidogrel, Ticagrelor, or aspirin; 12. Patients with a history of cardiogenic shock within two weeks; 13. pregnant and lactating women, during treatment can not be strict contraception of women of childbearing age; 14. In the past 3 months participated in other clinical researchers; 15. Persons who do not have legal or legal competence; 16. Any condition that the investigator considers unsuitable for participation in the clinical study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality | All-cause death and cardiac death | 5 years | 
| Net clinical adverse events | a composite of cardiac death, myocardial infarction (MI), revascularization, and bleeding (Bleeding Academic Research Consortium (BARC) definitions, type 2, 3, or 5), | 5 years | 
| bleeding events | BARC class 2 or higher bleeding events | 5 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| all-cause death | all-cause death | 5 years | 
| cardiac death | death for cardiac cause | 5 years | 
| stent thrombosis | according to the Academic Research Consortium criteria | 5 years | 
| myocardial infarction | defined in accordance with the universal definition proposed in 2007 | 5 years | 
| stroke | including ischemic stroke and hemorrhage | 5 years | 
| urgent revascularization | with persistent or increasing symptoms need to intervention | 5 years | 
| major adverse cardiovascular events (MACE) | defined as cardiac death, cardiac death, MI, stent thrombosis, or urgent revascularization | 5 years | 
| major adverse cardiovascular and cerebrovascular events (MACCE) | cardiac death, stroke, MI, stent thrombosis, or urgent revascularization | 5 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CYP2C19