Domenico G Della Rocca, Rodney P Horton, Luigi Di Biase, Carola Gianni, Chintan Trivedi, Sanghamitra Mohanty, Alisara Anannab, Michele Magnocavallo, Qiong Chen, Nicola Tarantino, Mohamed Bassiouny, Carlo Lavalle, Veronica N Natale, Giovanni B Forleo, Armando Del Prete, Christoffel Johannes Van Niekerk, Amin Al-Ahmad, J David Burkhardt, G Joseph Gallinghouse, Javier E Sanchez, Dhanunjaya Lakkireddy, Douglas N Gibson, Andrea Natale
OBJECTIVES: This study sought to report the incidence of device-related thrombosis (DRT) and thromboembolic (TE) events when an alternative to clopidogrel is prescribed in loss-of-function (LOF) allele carriers of the cytochrome P450 2C19 (CYP2C19) gene. BACKGROUND: LOF polymorphisms of the CYP2C19 gene are associated with reduced hepatic bioactivation of clopidogrel. METHODS: One thousand two Watchman patients were included. Six hundred forty-five patients underwent CYP2C19 genetic testing; among patients with clopidogrel resistance, clopidogrel was replaced by either prasugrel (pilot cohort) or half dose direct oral anticoagulant ((DOAC)/Group 1), both in combination with aspirin...
June 23, 2021: JACC. Clinical Electrophysiology