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Pharmacogenetics

Point-of-care genetic testing—a new frontier explored

Nature Reviews Cardiology volume 9, pages 315–316 (2012)Cite this article

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Much debate surrounds the utility of CYP2C19*2 genotyping in patients receiving clopidogrel after coronary artery stenting. The effectiveness of its use in a point-of-care setting has now been examined and, given the substantial incremental suppression of platelet reactivity achieved, its routine use might soon be a reality.

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Figure 1: PRU levels in carriers of the CYP2C19*2 allele in the RAPID GENE study.1

References

  1. Roberts, J. D. et al. Point-of-care genetic testing for personalisation of antiplatelet treatment (RAPID GENE): a prospective, randomised, proof-of-concept trial. Lancet http://dx.doi.org/10.1016/S0140-6736(12)60161-5.

  2. Mega, J. L. et al. Reduced-function CYP2C19 genotype and risk of adverse clinical outcomes among patients treated with clopidogrel predominantly for PCI: a meta-analysis. JAMA 304, 1821–1830 (2010).

    Article  CAS  Google Scholar 

  3. Price, M. J. et al. Prognostic significance of post-clopidogrel platelet reactivity assessed by a point-of-care assay on thrombotic events after drug-eluting stent implantation. Eur. Heart J. 29, 992–1000 (2008).

    Article  Google Scholar 

  4. Breet, N. J. et al. Comparison of platelet function tests in predicting clinical outcome in patients undergoing coronary stent implantation. JAMA 303, 754–762 (2010).

    Article  CAS  Google Scholar 

  5. Bonello, L. et al. Consensus and future directions on the definition of high on-treatment platelet reactivity to adenosine diphosphate. J. Am. Coll. Cardiol. 56, 919–933 (2010).

    Article  CAS  Google Scholar 

  6. Price, M. J. et al. Platelet reactivity and cardiovascular outcomes after percutaneous coronary intervention: a time-dependent analysis of the Gauging Responsiveness with a VerifyNow P2Y12 assay: Impact on Thrombosis and Safety (GRAVITAS) trial. Circulation 124, 1132–1137 (2011).

    Article  Google Scholar 

  7. Holmes, M. V., Perel, P., Shah, T., Hingorani, A. D. & Casas, J. P. CYP2C19 genotype, clopidogrel metabolism, platelet function, and cardiovascular events: a systematic review and meta-analysis. JAMA 306, 2704–2714 (2011).

    Article  CAS  Google Scholar 

  8. Patay, B. A. & Topol, E. J. The unmet need of education in genomic medicine. Am. J. Med. 125, 5–6 (2012).

    Article  Google Scholar 

  9. McCormack, M. et al. HLA-A*3101 and carbamazepine-induced hypersensitivity reactions in Europeans. N. Engl. J. Med. 364, 1134–1143 (2011).

    Article  CAS  Google Scholar 

  10. Chen, P. et al. Carbamazepine-induced toxic effects and HLA-B*1502 screening in Taiwan. N. Engl. J. Med. 364, 1126–1133 (2011).

    Article  CAS  Google Scholar 

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  1. Scripps Translational Science Institute, 3344 North Torrey Pines Court, Suite 300, La Jolla, 92037, CA, USA

    Paddy M. Barrett & Eric J. Topol

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  1. Paddy M. Barrett
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  2. Eric J. Topol
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Correspondence to Eric J. Topol.

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Competing interests

P. M. Barrett declares that he has received unrestricted grants or research support from Daiichi Sankyo and Menarini. E. J. Topol declares that he is a consultant for Quest Diagnostics.

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Barrett, P., Topol, E. Point-of-care genetic testing—a new frontier explored. Nat Rev Cardiol 9, 315–316 (2012). https://doi.org/10.1038/nrcardio.2012.63

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