Feasibility and implementation of CYP2C19 genotyping in patients using antiplatelet therapy

Pharmacogenomics. 2018 May;19(7):621-628. doi: 10.2217/pgs-2018-0013. Epub 2018 Apr 27.

Abstract

Aim: A tailored antiplatelet strategy based on CYP2C19 genotype may reduce atherothrombotic and bleeding events. We describe our experience with CYP2C19 genotyping, using on-site TaqMan or Spartan genotyping or shipment to a central laboratory.

Methodology: Data from two ongoing projects were used: Popular Risk Score project (non-urgent percutaneous coronary intervention patients) and the Popular Genetics study (ST-segment elevation myocardial infarction patients). For both projects, the time to genotyping result was calculated.

Results: In the Popular Risk Score project (n = 2556), median time from blood collection to genotyping result was 4:04 h. In the Popular Genetics study (n = 1038), median time from randomization to genotyping result was 2:24 h.

Conclusion: CYP2C19 genotyping is feasible in everyday clinical practice, both in the acute and non-acute settings.

Keywords: CYP2C19; PCI; STEMI; clopidogrel; genotyping; personalized medicine; pharmacogenomics; ticagrelor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cytochrome P-450 CYP2C19 / genetics*
  • Drug-Related Side Effects and Adverse Reactions / etiology
  • Drug-Related Side Effects and Adverse Reactions / genetics*
  • Drug-Related Side Effects and Adverse Reactions / prevention & control
  • Feasibility Studies
  • Genotype
  • Humans
  • Myocardial Infarction / drug therapy
  • Myocardial Infarction / genetics
  • Percutaneous Coronary Intervention / methods
  • Pharmacogenomic Testing / methods*
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / adverse effects*
  • Precision Medicine / methods*
  • Time Factors

Substances

  • Platelet Aggregation Inhibitors
  • CYP2C19 protein, human
  • Cytochrome P-450 CYP2C19