Application of Genetic Testing in Individualized Antiplatelet Therapy for Acute Coronary Syndrome Pa-tients after Percutaneous Coronary Intervention / 中国药房

ABSTRACT

OBJECTIVE:To investigate the value of genetic testing in clopidogrel individualized antiplatelet therapy for acute coronary syndrome(ACS)patients after percutaneous coronary intervention(PCI). METHODS:Clinical pharmacists participated in therapy for 3 ACS patients after PCI,and analyzed risk factors of stent thrombosis as the degree of lesion complexity,length and number of stents,complication,smoking history,etc. Clinical pharmacists suggested conducting clopidogrel genetic testing (CYP2C19,PON1,ACBC1),and suggested replacing antiplatelet agents,maintaining original plan and strengthening monitoring according to the results of genetic testing. RESULTS:The physicians adopted the suggestions of clinical pharmacists. After optimiz-ing antiplatelet therapy according to the results of genetic testing and clinical factors,3 patients were stable and discharged from hospital with drugs. CONCLUSIONS:Genetic testing can provide evidence for the formulation of individualized antiplatelet thera-py in ACS patients after PCI,and can be regarded as one of the breakthrough points for clinical pharmacists to carry out pharmaceu-tical care. In conducting genetic testing,clinical pharmacists should evaluate the risk of thrombosis in ACS patients and select the appropriate population for testing. At the same time,the clinical factors as medication compliance,stent thrombosis risk,therapeu-tic efficacy,ADR,and evidence-based pharmaceutical evidence should be comprehensively evaluated on the basis of genetic test-ing,and antiplatelet therapy plan should be optimized so as to guarantee the safety and effectiveness of drug use.