Projected impact of a multigene pharmacogenetic test to optimize medication prescribing in cardiovascular patients

Pharmacogenomics. 2018 Jun 1;19(9):771-782. doi: 10.2217/pgs-2018-0049. Epub 2018 May 25.

Abstract

Aim: To determine the projected impact of a multigene pharmacogenetic (PGx) test on medication prescribing.

Materials & methods: A retrospective analysis was conducted with 122 cardiac catheterization laboratory patients undergoing angiography for eligibility of potential PGx-guided interventions that could have occurred if multigene PGx information was pre-emptively available at the time of the procedure. Medication data and presence of actionable at-risk genotypes were used to determine eligibility of a PGx intervention.

Results: 20% of the study population (n = 24) would have qualified for at least one PGx-based medication intervention per US FDA or Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines within 6 months of their cardiac catheterization procedure. Commonly encountered gene-drug pairs for these interventions included: CYP2C19 for clopidogrel and antidepressants, CYP2D6 for antidepressants and codeine, SLCO1B1 for simvastatin, and VKORC1/CYP2C9 for warfarin.

Conclusion: Pre-emptive use of a multigene PGx test in the cardiac catheterization laboratory offers potential to reduce adverse medication outcomes.

Keywords: cardiovascular pharmacogenetics; multigene testing; pharmacogenetics; pharmacogenomics; pre-emptive genotyping.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiac Catheterization / methods
  • Cardiovascular System / drug effects*
  • Cardiovascular System / physiopathology
  • Cytochrome P-450 CYP2C19 / genetics
  • Cytochrome P-450 CYP2D6
  • Drug Prescriptions
  • Female
  • Genotype
  • Humans
  • Liver-Specific Organic Anion Transporter 1 / genetics
  • Male
  • Middle Aged
  • Pharmacogenetics / methods
  • Prescription Drugs / therapeutic use*
  • Retrospective Studies
  • Vitamin K Epoxide Reductases / genetics
  • Warfarin / therapeutic use

Substances

  • Liver-Specific Organic Anion Transporter 1
  • Prescription Drugs
  • Warfarin
  • Cytochrome P-450 CYP2C19
  • Cytochrome P-450 CYP2D6
  • Vitamin K Epoxide Reductases