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Pharmacogenomics in Cardiology
CYP2C19 Genotyping for optimal P2Y12 Inhibitor Therapy
- Every third patient is resistant to the antiaggregatory effect of clopidogrel due to loss-of-function (LOF) variants in the CYP2C19 gene1-3.
- The rate of major cardiovascular events (MACE) is doubled in those patients2
- Long term therapy with the alternative drugs Ticagrelor or Prasugrel has a higher risk of bleeding3,4.
- Use of Ticagrelor or Prasugrel only in patients with LOF variants achieves the lowest overall bleeding rate and optimal prevention of MACE 5
- Sanger sequencing of the variants CYP2C19 *2 and *3.
- DNA extraction from blood (3ml EDTA tubes).
- Results in 1-3 working days once received.
- CHF 590 as per list of analyses.
How to order
- Complete the informed consent (available at www.swissdnalysis.ch).
- Send the informed consent and blood by 1st class mail to:
Swiss DNAlysis, Adlerstrasse 1, CH-8600 Dübendorf
- Recommendations for Clinical CYP2C19 Genotyping Allele Selection. A report of the Association for Molecular Pathology. Victoria M. Pratt, et al., J Mol Diagn 2018;20:269-276.
- Clinical Utility of CYP2C19 Genotyping to Guide Antiplatelet Therapy in Patients With an Acute Coronary Syndrome or Undergoing Percutaneous Coronary Intervention. Melissa D. Klein, et al. Arterioscler Thromb Vasc Biol. 2019;39:647-652.
- Association of Ticagrelor vs Clopidogrel with Major Adverse Coronary Events in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention. Ricky D. Turgeon et al., JAMA Intern Med. Online January 13 2020.
- Prasugrel vs Clopidogrel in patients with acute coronary syndromes. Wiviott SD et al., N Eng J Med 2007;357(20):2001-15.
- A Genotype-Guided Strategy for Oral P2Y12Inhibitors in Primary PCI. Claassens DMF, et al. N Engl J Med. 2019;381(17):1621-1631.
- Genotype-guided treatment of oral P2Y12Inhibitors: where do we stand? Claassens DMF, Jurriën Mten Berg. Pharmacogenomics 2020;21(2):83-86.
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