Journal
PHARMACOGENOMICS
Volume 16, Issue 4, Pages 303-313Publisher
FUTURE MEDICINE LTD
DOI: 10.2217/PGS.14.180
Keywords
clopidogrel; pharmacogenomics; prasugrel; stent; ticagrelor
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Aim: An algorithm that uses clinical factors and CYP2C19 genotype to guide P2Y(12) inhibitor selection in high-risk patients undergoing percutaneous coronary intervention was implemented at our institution. We sought to evaluate use of this algorithm and identify which factors influenced P2Y(12) inhibitor selection. Patients & methods: This retrospective cohort study included 264 patients receiving percutaneous coronary intervention from July-December 2012. Results: CYP2C19 genotype was obtained in 229 patients; of these, 30% were intermediate or poor metabolizers. CYP2C19 intermediate or poor metabolizer phenotype was among the strongest predictors for selecting prasugrel or ticagrelor as maintenance therapy (p < 0.001), and was the only significant predictor of a change in therapy (p < 0.001). Conclusion: These findings suggest that using CYP2C19 genotype to guide P2Y(12) inhibitor selection is feasible.
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