Evidence map›Paper›PMID 27100112›Full record

Observational studyJournal of thrombosis and thrombolysis2016

Impact of an integrated treatment algorithm based on platelet function testing and clinical risk assessment: results of the TRIAGE Patients Undergoing Percutaneous Coronary Interventions To Improve Clinical Outcomes Through Optimal Platelet Inhibition study.

Jaya Chandrasekhar, Usman Baber, Roxana Mehran, Melissa Aquino, Samantha Sartori, Jennifer Yu, Annapoorna Kini, Samin Sharma, Carsten Skurk, Richard A Shlofmitz and 2 more

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of thrombosis and thrombolysis, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 2 countries.

Jaya ChandrasekharIcahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, PO Box 1030, New York, NY, USA.
Usman BaberIcahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, PO Box 1030, New York, NY, USA.
Roxana MehranIcahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, PO Box 1030, New York, NY, USA.
Melissa AquinoIcahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, PO Box 1030, New York, NY, USA.
Samantha SartoriIcahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, PO Box 1030, New York, NY, USA.
Jennifer YuIcahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, PO Box 1030, New York, NY, USA.
Annapoorna KiniMount Sinai Hospital, New York, NY, USA.
Samin SharmaMount Sinai Hospital, New York, NY, USA.
Carsten SkurkCharité University Hospital, Berlin, Germany.
Richard A ShlofmitzSt. Francis Hospital, New York, NY, USA.
Bernhard WitzenbichlerHELIOS Amper-Klinikum Dachau, Dachau, Germany.
George DangasIcahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, PO Box 1030, New York, NY, USA. george.dangas@mountsinai.org.
Icahn School of Medicine at Mount Sinai · USMount Sinai Hospital · USCharité - Universitätsmedizin Berlin · DEHelios Amper-Klinikum Dachau · DESt. Francis Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Assessment of platelet reactivity alone for thienopyridine selection with percutaneous coronary intervention (PCI) has not been associated with improved outcomes. In TRIAGE, a prospective multicenter observational pilot study we sought to evaluate the benefit of an integrated algorithm combining clinical risk and platelet function testing to select type of thienopyridine in patients undergoing PCI. Patients on chronic clopidogrel therapy underwent platelet function testing prior to PCI using the VerifyNow assay to determine high on treatment platelet reactivity (HTPR, ≥230 P2Y12 reactivity units or PRU). Based on both PRU and clinical (ischemic and bleeding) risks, patients were switched to prasugrel or continued on clopidogrel per the study algorithm. The primary endpoints were (i) 1-year major adverse cardiovascular events (MACE) composite of death, non-fatal myocardial infarction, or definite or probable stent thrombosis; and (ii) major bleeding, Bleeding Academic Research Consortium type 2, 3 or 5. Out of 318 clopidogrel treated patients with a mean age of 65.9 ± 9.8 years, HTPR was noted in 33.3 %. Ninety (28.0 %) patients overall were switched to prasugrel and 228 (72.0 %) continued clopidogrel. The prasugrel group had fewer smokers and more patients with heart failure. At 1-year MACE occurred in 4.4 % of majority HTPR patients on prasugrel versus 3.5 % of primarily non-HTPR patients on clopidogrel (p = 0.7). Major bleeding (5.6 vs 7.9 %, p = 0.47) was numerically higher with clopidogrel compared with prasugrel. Use of the study clinical risk algorithm for choice and intensity of thienopyridine prescription following PCI resulted in similar ischemic outcomes in HTPR patients receiving prasugrel and primarily non-HTPR patients on clopidogrel without an untoward increase in bleeding with prasugrel. However, the study was prematurely terminated and these findings are therefore hypothesis generating.

Indexed as

AgedAlgorithmsClinical Decision-MakingClopidogrelHemorrhageHumansMiddle AgedPercutaneous Coronary InterventionPlatelet Aggregation InhibitorsPlatelet Function TestsPrasugrel HydrochlorideProspective StudiesRisk AssessmentThienopyridinesTiclopidineTreatment OutcomeClopidogrelPlatelet Aggregation InhibitorsPrasugrel HydrochlorideThienopyridinesTiclopidineHigh on treatment platelet reactivityPlatelet function testingPotent P2Y12 receptor inhibitorThienopyridine switchingVerifyNow assay

Identifiers

PMID27100112
OpenAlexW2336737124

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.