[HTML][HTML] Mutational analysis clopidogrel resistance and platelet function in patients scheduled for coronary artery bypass grafting

M Correll, CK Johnson, G Ferrari, M Brizzio, AWC Mak… - Genomics, 2013 - Elsevier
M Correll, CK Johnson, G Ferrari, M Brizzio, AWC Mak, J Quackenbush, RE Shaw…
Genomics, 2013Elsevier
Clopidogrel is an oral antiplatelet pro-drug prescribed to 40million patients worldwide who
are at risk for thrombotic events or receiving percutaneous coronary intervention (PCI).
However about a fifth of patients treated with clopidogrel do not respond adequately to the
drug. From a cohort of 105 patients on whom we had functional data on clopidogrel
response, we used ultra-high throughput sequencing to assay mutations in CYP2C19 and
ABCB1, the two genes genetically linked to respond. Testing for mutations in CYP2C19, as …
Clopidogrel is an oral antiplatelet pro-drug prescribed to 40million patients worldwide who are at risk for thrombotic events or receiving percutaneous coronary intervention (PCI). However about a fifth of patients treated with clopidogrel do not respond adequately to the drug. From a cohort of 105 patients on whom we had functional data on clopidogrel response, we used ultra-high throughput sequencing to assay mutations in CYP2C19 and ABCB1, the two genes genetically linked to respond. Testing for mutations in CYP2C19, as recommended by the FDA, only correctly predicted if a patient would respond to clopidogrel 52.4% of the time. Similarly, testing of the ABCB1 gene only correctly foretold response in 51 (48.6%) patients. These results are clinically relevant and suggest that until additional genetic factors are discovered that predict response more completely, functional assays are more appropriate for clinical use.
Elsevier