Contemporary use of platelet function and pharmacogenomic testing among acute myocardial infarction patients treated with PCI in the United States: insights from the TRANSLATE-ACS study

Abstract

Purpose: Although platelet function and pharmacogenomic testing have been studied in clinical trials of patients undergoing PCI, the adoption of platelet testing into contemporary U.S. clinical practice is unknown. Methods: We studied patterns of platelet function and pharmacogenomic testing among 9308 acute MI patients treated with PCI in the TRANSLATE-ACS observational study from 04/2010-10/2012. Patients receiving research protocol-mandated platelet function testing were excluded. Results: Overall, 276 (3%) patients underwent pre-discharge platelet function testing and 83 (0.9%) underwent pharmacogenomic testing. Among 218 U.S. hospitals participating in TRANSLATE-ACS, platelet function tests were performed in only 38 hospitals (17%), while only 15 (7%) performed pharmacogenomic testing. There were no differences in age or baseline risk factors between patients with and without platelet testing (Table). Compared with patients without platelet testing, patients with testing were more likely to have had a prior PCI, more likely to be on an ADP receptor inhibitor prior to the index MI hospitalization, and were more likely to be discharged on or switched from clopidogrel to a 2nd generation ADP inhibitor such as prasugrel or ticagrelor before hospital discharge. View this table: Platelet testing vs. no testing Conclusions: Platelet testing is used rarely in contemporary MI patients undergoing PCI in the U.S.; however, when platelet testing was used, patients were more likely to be discharged on higher potency ADP inhibitors.