Abstract 14707: International Survey of Patients Undergoing Percutaneous Coronary Intervention and Their Attitudes Towards Pharmacogenetic Testing.

Background: The black box warning for clopidogrel recommends genetic testing to identify CYP2C19 poor metabolizers. The opinions of patients undergoing percutaneous coronary intervention (PCI) towards genetic testing are unknown. Methods: TAILOR-PCI is the largest genotype-based cardiovascular clinical trial randomizing participants to conventional or prospective genotyping guided anti-platelet therapy. Subjects completed surveys prior to and six-months after randomization. Results: A total of 1,327 subjects completed the baseline and 860 completed the six-month survey. At baseline, 77% were males and the average age was 63 years. There were 28%, 29%, and 43% subjects from Korea, Canada and the United States (U.S.), respectively. The majority of subjects (77%) valued identifying pharmacogenetic variants as important to their healthcare however there were clear geographic differences with 44% of Koreans, in contrast to 91% of Canadians, and 89% of US subjects (P <0.001) identifying pharmacogenetics as being important. This observation persisted even after adjustment for age and sex (OR, 95% CI versus USA: Canada 1.21, 0.78-1.86; Korea 0.10, 0.07-0.14). This perception could be related to a knowledge or confidence gap, as only 21% of Koreans, as opposed to 86% and 77% (P <0.001) of subjects in Canada and U.S., respectively, were confident in their ability to understand genetic information. These significant differences persisted in the six-month follow-up survey. Across all subjects at baseline, those who were confident were significantly more likely to value identifying pharmacogenetic variants (OR 30.0, 95% CI 20.5, 43.8). This association was significant after adjusting for age, sex, and country. There was a significant interaction (p=0.005) with country of enrollment with a weaker association seen in the USA (OR 8.94) compared to Canada (OR 34.0) and Korea (OR 42.8). Conclusions: Although genetically mediated clopidogrel resistance is more prevalent amongst Asians, Koreans undergoing PCI believed identifying pharmacogenetic variants were less important to their healthcare, a finding associated with their stated confidence in their ability to understand genetic information. [ABSTRACT FROM AUTHOR]