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Clopidogrel metabol...
Clopidogrel metaboliser status based on point-of-care CYP2C19 genetic testing in patients with coronary artery disease
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- Erlinge, David (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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- James, Stefan K. (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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Duvvuru, Suman (author)
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Jakubowski, Joseph A. (author)
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- Wagner, Henrik (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Varenhorst, Christoph (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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Tantry, Udaya S. (author)
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Brown, Patricia B. (author)
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Small, David (author)
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Moser, Brian A. (author)
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Sundseth, Scott S. (author)
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Walker, Joseph R. (author)
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Winters, Kenneth J. (author)
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Gurbel, Paul A. (author)
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(creator_code:org_t)
- 2014
- 2014
- English.
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In: Thrombosis and Haemostasis. - 0340-6245 .- 2567-689X. ; 111:5, s. 943-950
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http://dx.doi.org/10...
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Abstract
Subject headings
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- We compared results obtained with the Nanosphere Verigene (R) System, a novel point-of-care (POC) genetic test capable of analysing 11, CYP2C19 variants within 3 hours, to an established, validated genotyping method (Affymetrix (TM) DMET+; reference assay) for identifying extensive and reduced metabolisers of clopidogrel. Based on genotyping, patients (N=82) with stable coronary artery disease on clopidogrel 75 mg daily were defined as extensive metabolisers (*1/*1, *1/*17,*17/*17), reduced metabolisers (*1/*2,*1/*8,*2/*2,*2/*3), or of indeterminate metaboliser status (*2/*17). Pharmacokinetic exposure to clopidogrel's active metabolite and pharmacodynamic measures with P2Y12 reaction units (PRU) (VerifyNow (R) P2Y12 assay), and VASP PRI (PRI) were also assessed. There was a 99.9% overall; concordance of marker-level data between the Nanosphere Verigene and DMET+ systems in identifying the CYP2C19 variants and 100% agreement in classifying the patients as extensive (n=59) or reduced metabolisers (n=15). Extensive metabolisers had significantly higher active metabolite exposure than reduced metabolisers (LS means 12.6 ng*h/ml vs 7.7 ng*h/ml; p<0.001). Extensive metabolisers also had lower PRU (LS means 158 vs 212; p=0.003) and VASP PRI (LS means 48% vs 63%, p=0.01) compared to reduced metabolisers. Rates of high on-treatment platelet reactivity were higher in reduced metabolisers compared to extensive metabolisers (VASP PRI >= 50%: 79% vs 47%; PRU >235: 33% vs 16%). The Nanosphere Verigene CBS system identified 11 CYP2C19 alleles in less than 3 hours with a high degree of accuracy when compared to a conventional method, and was further validated against pharmacokinetic and pharmacodynamic phenotypes.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Genotyping techniques
- clopidogrel
- prasugrel
- pharmacogenetics CYP2C19 polymorphisms
Publication and Content Type
- ref (subject category)
- art (subject category)
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To the university's database
- By the author/editor
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Erlinge, David
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James, Stefan K.
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Duvvuru, Suman
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Jakubowski, Jose ...
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Wagner, Henrik
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Varenhorst, Chri ...
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show more...
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Tantry, Udaya S.
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Brown, Patricia ...
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Small, David
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Moser, Brian A.
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Sundseth, Scott ...
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Walker, Joseph R ...
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Winters, Kenneth ...
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Gurbel, Paul A.
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Hematology
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Thrombosis and H ...
- By the university
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Uppsala University
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Lund University