Cardiovascular Disease Study
The Tailored Antiplatelet Initiation to Lessen Outcomes Due to Decreased Clopidogrel Response After Percutaneous Coronary Intervention (TAILOR-PCI) study uses genetic information to determine the best medication for patients who undergo coronary angioplasty, also known as percutaneous coronary intervention.
The current standard of practice is to prescribe clopidogrel (Plavix) for one year. However, up to 30 percent of those who undergo angioplasty have a genetic variation in the CYP2C19 liver enzyme that interferes with clopidogrel metabolization. For these patients, an alternative antiplatelet medication, such as ticagrelor (Brilinta), may be more effective, have fewer side effects, and reduce repeat hospital and clinic visits.
The TAILOR-PCI study uses rapid genotyping to identify people who are intermediate or poor metabolizers of clopidogrel and, therefore, at potentially high risk of having a decreased response to clopidogrel. This information is used to guide antiplatelet medication decisions in patient care.
If genotyping can predict the right drug for each person, it minimizes side effects and improves outcomes. The results of this study could immediately affect patient care and impact the practices in cardiac catherization labs around the country — and potentially around the world.
Participants undergo coronary angioplasty at Mayo Clinic and participate in three follow-up phone interviews.
Eligible participants may include those who:
- Plan to undergo coronary angioplasty for acute coronary syndrome or coronary artery disease
- Require antiplatelet therapy for one year after angioplasty
You are closely monitored by the Mayo team. If you are among the 30 percent of people who have an abnormal variant of the CYP2C19 liver enzyme, which interferes with the ability to metabolize clopidogrel, you may receive a medication more effective for you (dependent on randomization).
You are randomly assigned to one of two study groups. The first group receives rapid genetic testing in the form of a cheek swab at the time of enrollment. The other group receives standard antiplatelet treatment of clopidogrel and genetic testing after one year.
If you are in the rapid genetic testing group, you receive either clopidogrel or ticagrelor based on your genetic test results. Those participants with a variant in the CYP2C19 liver enzyme gene receive ticagrelor. All others are prescribed clopidogrel.
Patients, referring physicians and research collaborators can contact our TAILOR-PCI study coordinator for more information:
Rebekah R. Herrmann, R.N.
Our study team will enroll approximately 6,000 patients from Mayo Clinic's campuses in Rochester, Minn.; Phoenix/Scottsdale, Ariz.; and Jacksonville, Fla.; and from Mayo Clinic Health System locations in Mankato, Minn., and La Crosse, Wis. We are also working with four of the top cardiology centers in Canada.
You can also contact the Center for Individualized Medicine for information on other studies and trials.
Support this study
The TAILOR-PCI study represents a unique opportunity to garner a large and diverse repository of samples from patients with coronary artery disease for future research.
Your support helps develop new treatment plans, reduce the number of hospital readmissions and improve outcomes for patients with certain types of cardiovascular disease.
Your generosity allows Mayo Clinic to expand and extend the advancements made in the Center for Individualized Medicine to patients at Mayo and around the world.