Original Research
Tuesday, October 15, 2024
08:30 AM–10:00 AM
Abstract
Introduction:
The ABCD-GENE score, which includes Age, Body mass index, Chronic kidney disease (CKD; estimated glomerular filtration rate [eGFR] <60 mL/min/1,73m2), Diabetes, and CYP2C19 GENE variants, is associated with high platelet reactivity (HPR) and increased risk for major cardiovascular events (MACE) in clopidogrel-treated patients following percutaneous coronary innervation (PCI); a score = 10 predicts increased risk. However, genotype information might not be available for patients undergoing PCI.
Research Question or Hypothesis:
We sought to determine if the ABCD score alone (without genotype) is predictive of risk for MACE in clopidogrel-treated patients after PCI.
Study Design:
Multi-center, cohort study
Methods:
The ABCD score was calculated for individuals treated with clopidogrel following PCI. Points are allocated as follows: 4 points for age>75 years, 4 points for BMI >30 kg/m², 3 points for diabetes, and 3 points for CKD. The primary outcome of MACE, defined as the composite of cardiovascular death, myocardial infarction, ischemic stroke, or stent thrombosis, was compared between patients with an ABCD score <10 vs =10. Kaplan-Meier analysis and Cox proportional-hazards regression was performed after adjusting for multiple factors (e.g., gender, smoking status, PCI indication, stent type, and site).
Results:
Of 2,770 patients included (mean age 64±12, 20% (n=567) Black, and 35% (n=968) female), 314 (11%) had a score =10. The risk of MACE was higher among patients with a score =10 vs <10 (10.2 vs 5.5 events per 100 patient-years, adjusted HR 1.95, 95% CI 1.30-2.90, P=0.001).
Conclusion:
An ABCD score of =10 was associated with an increased risk of MACE in post-PCI clopidogrel-treated patients. Whether alternative P2Y12 inhibitor therapy reduces this risk remains to be determined.
Presenting Author
Maryam J. Al Saeed Pharm.D., MSUniversity of Florida
Authors
Dominick J. Angiolillo MD, PhD
University of Florida
Amber L. Beitelshees PharmD, MPH
University of Maryland School of Medicine
Larisa H. Cavallari Pharm.D., BCPS, FCCP
University of Florida
Julio D. Duarte Pharm.D., Ph.D.
University of Florida, College of Pharmacy
Francesco Franchi MD
University of Florida
Yan Gong Ph.D.
University of Florida
Ellen C. Keeley MD, MS
University of Florida
Craig R. Lee PharmD, PhD, FCCP
UNC Eshelman School of Pharmacy, UNC-Chapel Hill
Joseph S. Rossi MD, MSCI
UNC Medical Center
George A. Stouffer MD
UNC School of Medicine
Cameron D. Thomas Pharm.D.
UF College of Pharmacy
Caitrin W. McDonough Ph.D.
University of Florida