The Diagnostic Utility of the Point-of-Care CYP2C19 Genotyping Assay in Patients with Acute Coronary Syndrome Dosing Clopidogrel: Comparison with Platelet Function Test and SNP Genotyping.
Ann Clin Lab Sci
; 46(5): 489-94, 2016 Sep.
Article
em En
| MEDLINE
| ID: mdl-27650615
ABSTRACT
BACKGROUND:
Clopidogrel is a widely used antiplatelet agent for dual antiplatelet therapy and metabolized by CYP2C19. The polymorphism of CYP2C19 is associated with the therapeutic effect of clopidogrel.METHODS:
A total of 119 patients diagnosed with acute coronary syndrome (ACS) and underwent percutaneous coronary intervention (PCI) with drug-eluting stents was enrolled. Polymorphisms of CYP2C19 *2,*3,*17 were determined by the Spartan RX CYP2C19 and confirmed by SNP genotyping assay. Genotype was grouped as ultra-rapid metabolizer, extensive metabolizer, intermediate metabolizer, and poor metabolizer. The degree of platelet inhibition was assessed by the VerifyNow P2Y12 system (Accumetrics, USA).RESULTS:
The CYP2C19 genotypes were distributed as 4 (3.3%) for UM, 39 (32.8%) for EM, 54 (45.4%) for IM, 22 (18.5%) for PM by evaluation with Spartan RX CYP2C19. The numbers of patients with the *1/*17, *1/*1, *1/*2, *1/*3, *3/*17, *2/*2, *2/*3, and *3/*3 genotype were 4 (3.3%), 39 (32.8%), 40 (33.6%), 13 (10.9%), 1 (0.9%), 11 (9.2%), 10 (8.4%), 1 (0.9%), respectively. The genotyping results between Spartan RX CYP2C19 and SNP genotyping assay showed discrepancy in 2 patients. The discrepancy appeared in *17 allele analysis in both patients as false-positive result.CONCLUSIONS:
The false-positive *17 allele couldn't affect IM or PM group associated with thrombotic events, but it could affect UM group associated with bleeding events, which is relatively less investigated. Although the supplement of *17 allele detection should be accomplished, this novel point-of-care CYP2C19 genotyping instrument could determine the response to the clopidogrel and support the appropriate treatment of ACS patients.Palavras-chave
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ticlopidina
/
Sistemas Automatizados de Assistência Junto ao Leito
/
Polimorfismo de Nucleotídeo Único
/
Síndrome Coronariana Aguda
/
Técnicas de Genotipagem
/
Citocromo P-450 CYP2C19
Tipo de estudo:
Diagnostic_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Ann Clin Lab Sci
Ano de publicação:
2016
Tipo de documento:
Article