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Results of the GIANT trial reported at TCT 2013
Date:11/1/2013

therapy (DAPT) was prescribed for 12 months after PCI and one year follow up was performed in 96.4 percent of patients (n=1,445) including objective assessment of compliance. A total of 22 percent of patients (n=319) had a profile associated with a CYP2C19 loss of function, known as the slow responder group. The remaining patients constituted the control group.

In the slow responder group, 85 percent received an adjusted thienopyridine regimen after the release of the genetic profile. Within the slow responder group, the patients that did receive adjusted therapy experienced fewer adverse events compared to those that did not have adjusted therapy (3.3 percent vs. 15.6 percent, respectively) after one year. Further, the patients that received adjusted therapy experienced a similar rate of adverse events as the control group (3.3 percent vs. 3.04 percent). Poor compliance to treatment was objectively identified in 4.9 percent of patients at one year, and those patients experienced numerically more ischemic events.

"Results from the GIANT trial suggest that in patients with acute myocardial infarction treated with primary PCI, identification of a slow response to clopidogrel with subsequent adjustment of treatment leads to similar one year major ischemic event rates to patients with a favorable genetic profile to clopidogrel response," said lead investigator Bernard R. Chevalier, MD from L'Institut CardioVasculaire Paris-Sud in Massy, France.

"These findings may help determine alternative treatment strategies for patients identified as CYP2C19 poor metabolizers."


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Contact: Judy Romero
jromero@crg.org
Cardiovascular Research Foundation
Source:Eurekalert

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