Cardiovascular Disease: TAILOR-PCI 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.

Participation

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.

Contact

Patients, referring physicians and research collaborators can contact the TAILOR-PCI study coordinator for more information. Use our contact form and select "Clinical Studies-Cardiovascular Disease" in the dropdown menu.

Our study team will enroll approximately 6,000 patients through an international collaboration of 25 hospitals in the United States, Canada and South Korea. Collaborating institutions include:

United States

• Mayo Clinic
  • Phoenix/Scottsdale, Arizona
  • Jacksonville, Florida
  • Rochester, Minnesota
• Mayo Clinic Health System
  • Eau Claire, Wisconsin
  • La Crosse, Wisconsin
• Mayo Clinic Care Network
  • NCH Heart Institute, Naples, Florida
  • NorthShore University HealthSystem, Evanston, Illinois
  • St. Elizabeth Healthcare, Edgewood, Kentucky
• Unaffiliated collaborators
  • Albany Medical Center, Albany, New York
  • Aurora Research Institute, Milwaukee, Wisconsin
  • Columbia University Medical Center, New York City, New York
  • Essentia Health-St. Mary's Medical Center, Duluth, Minnesota
  • Intermountain Medical Center, Murray, Utah
  • Greenville Health System, Greenville, South Carolina
  • Lenox Hill Hospital, New York City, New York
  • Minneapolis Heart Institute, Minneapolis, Minnesota
  • The Miriam Hospital, Providence, Rhode Island
  • Rhode Island Hospital, Providence, Rhode Island
  • Sharp Healthcare, Center for Research, San Diego, California
  • University of Mississippi Medical Center, Jackson, Mississippi
  • Winthrop University Hospital, Mineola, New York

Canada

• St. Michael's Hospital, Toronto, Ontario
• Sunnybrook Health Sciences Centre, Toronto, Ontario
• Toronto General Hospital-UHN, Toronto, Ontario
• University of Ottawa Heart Institute, Ottawa, Ontario
• Vancouver General Hospital, Vancouver, British Columbia

South Korea

• Ajou University Hospital, Suwon
• Chonnam National University, Gwangju
• Chung-Ang University Hospital, Hwasun, Jelloanam-do
• Konyang University Hospital, Daejon

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.

Support individualized medicine