학술논문

Implementation and evaluation of a CYP2C19 genotype-guided antiplatelet therapy algorithm in high-risk coronary artery disease patients
Document Type
Report
Source
Pharmacogenomics. March 2015, Vol. 16 Issue 4, p303, 11 p.
Subject
Algorithms -- Usage
Cytochrome P-450 -- Identification and classification
Coronary heart disease -- Genetic aspects -- Development and progression
Angioplasty -- Patient outcomes
Health
Algorithm
Identification and classification
Usage
Development and progression
Genetic aspects
Patient outcomes
Language
English
ISSN
1462-2416
Abstract
Aim: An algorithm that uses clinical factors and CYP2C19 genotype to guide P2Y.sub.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.sub.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 [less than] 0.001), and was the only significant predictor of a change in therapy (p [less than] 0.001). Conclusion: These findings suggest that using CYP2C19 genotype to guide P2Y.sub.12 inhibitor selection is feasible. Original submitted 27 October 2014; revision submitted 19 December 2014
Author(s): John Andrew Lee [sup.aff1] , Craig R Lee [sup.aff1] [sup.aff2] [sup.aff3] , Brent N Reed [sup.aff4] , David C Plitt [sup.aff5] , Melissa J Polasek [sup.aff1] , Lucius A [...]