Genotyping aids medication decisions and benefits heart procedure patients

Every year more than half a million people in the US have stents placed in narrow blood vessels to improve blood flow to the heart. Following the procedure, patients typically need treatment with anti-clotting drugs. The go-to medication is clopidogrel, a prodrug that requires activation by an enzyme called CYP2C19. However, about a third of patients carry variants that render CYP2C19 ineffective. These patients are at increased risk for future heart attacks, strokes and other cardiovascular events. Prasugrel and ticagrelor are examples of alternative anti-clotting medications, but these therapies have been shown to have higher bleeding rates and are typically more expensive than clopidogrel. In clinical practice, switching between clopidogrel and either prasugrel or ticagrelor has become common. In a recent study published in GIM, researchers demonstrate how using CYP2C19 genotyping to guide medication decisions can benefit patients. GenePod host Cynthia Graber chats with the study’s lead author, Dr. Craig Lee, about the work on this month’s podcast. Article Link: https://www.nature.com/articles/s41436-019-0611-1