Naveen L Pereira1,2, Derek So3, Jang-Ho Bae4, Ivan Chavez5, Myung Ho Jeong6, Sang Wook Kim7, Mina Madan8, John Graham9, Fearghas O'Cochlain10, Nicole Pauley1, Ryan J Lennon11, Kent Bailey11, Ahmed Hasan12, Linnea M Baudhuin13, Malcolm R Bell1, Amir Lerman1, Shaun Goodman9, Verghese Mathew14, Michael Farkouh9, Charanjit S Rihal1. 1. Department of Cardiovascular Medicine. 2. Department of Molecular Pharmacology and Experimental Therapeutics. 3. Department of Medicine, University of Ottawa Heart Institute, Ottawa. 4. Department of Interventional Cardiology, Internal Medicine, Division of Cardiology, Konyang University, Nonsan. 5. Department of Cardiology, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota. 6. Department of Cardiology, Heart Research Center, Chonnam National University, Gwangju. 7. Department of Cardiology, Chung-Ang University Hospital, Seoul, South Korea. 8. Department of Medicine, Sunnybrook Health Sciences Centre. 9. Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. 10. Department of Medicine, Mayo Clinic Health System, Eau Claire Hospital Inc., Eau Claire, Wisconsin. 11. Department of Health Sciences Research. 12. Atherothrombosis and Coronary Artrey Disease Department, National Heart, Lung, and Blood Institute, Bethesda, Maryland. 13. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester. 14. Department of Medicine, Loyola University, Mayowood, Illinois, USA.
Abstract
OBJECTIVE: To evaluate perceptions toward pharmacogenetic testing of patients undergoingpercutaneous coronary intervention (PCI) who are prescribed dual antiplatelet therapy (DAPT) and whether geographical differences in these perceptions exist. PARTICIPANTS AND METHODS: TAILOR-PCI is the largest genotype-based cardiovascular clinical trial randomizing participants to conventional DAPT or prospective genotyping-guided DAPT. Enrolled patients completed surveys before and 6 months after randomization. RESULTS: A total of 1327 patients completed baseline surveys of whom 28, 29, and 43% were from Korea, Canada and the USA, respectively. Most patients (77%) valued identifying pharmacogenetic variants; however, fewer Koreans (44%) as compared with Canadians (91%) and USA (89%) patients identified pharmacogenetics as being important (P<0.001). After adjusting for age, sex, and country, those who were confident in their ability to understand genetic information were significantly more likely to value identifying pharmacogenetic variants (odds ratio: 30.0; 95% confidence interval: 20.5-43.8). Only 21% of Koreans, as opposed to 86 and 77% of patients in Canada and USA, respectively, were confident in their ability to understand genetic information (P<0.001). CONCLUSION: Although genetically mediated clopidogrel resistance is more prevalent amongst Asians, Koreans undergoing PCI identified pharmacogenetic variants as less important to their healthcare, likely related to their lack of confidence in their ability to understand genetic information. To enable successful implementation of pharmacogenetic testing on a global scale, the possibility of international population differences in perceptions should be considered.
RCT Entities:
OBJECTIVE: To evaluate perceptions toward pharmacogenetic testing of patients undergoing percutaneous coronary intervention (PCI) who are prescribed dual antiplatelet therapy (DAPT) and whether geographical differences in these perceptions exist. PARTICIPANTS AND METHODS: TAILOR-PCI is the largest genotype-based cardiovascular clinical trial randomizing participants to conventional DAPT or prospective genotyping-guided DAPT. Enrolled patients completed surveys before and 6 months after randomization. RESULTS: A total of 1327 patients completed baseline surveys of whom 28, 29, and 43% were from Korea, Canada and the USA, respectively. Most patients (77%) valued identifying pharmacogenetic variants; however, fewer Koreans (44%) as compared with Canadians (91%) and USA (89%) patients identified pharmacogenetics as being important (P<0.001). After adjusting for age, sex, and country, those who were confident in their ability to understand genetic information were significantly more likely to value identifying pharmacogenetic variants (odds ratio: 30.0; 95% confidence interval: 20.5-43.8). Only 21% of Koreans, as opposed to 86 and 77% of patients in Canada and USA, respectively, were confident in their ability to understand genetic information (P<0.001). CONCLUSION: Although genetically mediated clopidogrel resistance is more prevalent amongst Asians, Koreans undergoing PCI identified pharmacogenetic variants as less important to their healthcare, likely related to their lack of confidence in their ability to understand genetic information. To enable successful implementation of pharmacogenetic testing on a global scale, the possibility of international population differences in perceptions should be considered.
Authors: Jessica L Mega; Sandra L Close; Stephen D Wiviott; Lei Shen; Richard D Hockett; John T Brandt; Joseph R Walker; Elliott M Antman; William Macias; Eugene Braunwald; Marc S Sabatine Journal: N Engl J Med Date: 2008-12-22 Impact factor: 91.245
Authors: Larisa H Cavallari; Craig R Lee; Amber L Beitelshees; Rhonda M Cooper-DeHoff; Julio D Duarte; Deepak Voora; Stephen E Kimmel; Caitrin W McDonough; Yan Gong; Chintan V Dave; Victoria M Pratt; Tameka D Alestock; R David Anderson; Jorge Alsip; Amer K Ardati; Brigitta C Brott; Lawrence Brown; Supatat Chumnumwat; Michael J Clare-Salzler; James C Coons; Joshua C Denny; Chrisly Dillon; Amanda R Elsey; Issam S Hamadeh; Shuko Harada; William B Hillegass; Lindsay Hines; Richard B Horenstein; Lucius A Howell; Linda J B Jeng; Mark D Kelemen; Yee Ming Lee; Oyunbileg Magvanjav; May Montasser; David R Nelson; Edith A Nutescu; Devon C Nwaba; Ruth E Pakyz; Kathleen Palmer; Josh F Peterson; Toni I Pollin; Alison H Quinn; Shawn W Robinson; Jamie Schub; Todd C Skaar; D Max Smith; Vindhya B Sriramoju; Petr Starostik; Tomasz P Stys; James M Stevenson; Nicholas Varunok; Mark R Vesely; Dyson T Wake; Karen E Weck; Kristin W Weitzel; Russell A Wilke; James Willig; Richard Y Zhao; Rolf P Kreutz; George A Stouffer; Philip E Empey; Nita A Limdi; Alan R Shuldiner; Almut G Winterstein; Julie A Johnson Journal: JACC Cardiovasc Interv Date: 2017-11-01 Impact factor: 11.195
Authors: Janet E Olson; Carolyn R Rohrer Vitek; Elizabeth J Bell; Michaela E McGree; Debra J Jacobson; Jennifer L St Sauver; Pedro J Caraballo; Joan M Griffin; Veronique L Roger; Suzette J Bielinski Journal: Genet Med Date: 2017-01-05 Impact factor: 8.822
Authors: Grace Lee; Lisa A Varughese; Laura Conway; Carol Stojinski; Sandhya Ashokkumar; Karen Monono; William Matthai; Daniel M Kolansky; Jay Giri; Sony Tuteja Journal: Per Med Date: 2022-01-05 Impact factor: 2.512
Authors: Joseph O'Shea; Cristín Ryan; Joseph Gallagher; Claire O'Brien; Conor Morris; Eoin Dwyer; James Mc Laughlin; Laura Fitzpatrick; Maire O'Meara; Sarah Kelly; Sophie Knox; Mark Ledwidge Journal: Explor Res Clin Soc Pharm Date: 2022-09-21