Inside the Diagnostics Industry: Genotyping to Guide Antiplatelet Selection Feasible, Effective

Despite years of frustration that pharmacogenomic testing for antiplatelet therapy dosing has not been adopted as hoped in the field of cardiology, new evidence is emerging that genetic testing should be employed to guide therapy decisions. CYP2C19 testing has not been adopted in widespread practice due to conflicting recommendations for its use, as well as uncertainty over its effectiveness its real-world feasibility to inform treatment decisions in a timely matter. Several recent studies are providing evidence to overcome these concerns. Importantly, the recent studies show that genetic test results are significantly influencing cardiologists’ treatment decisions, which may ultimately improve patient outcomes. Genotyping Improves Patient Outcomes Patients who receive genotyping to guide the choice of antiplatelet therapy are significantly less likely to experience a primary endpoint event—a composite of myocardial infarction, stroke, cardiovascular death, and major bleeding—compared with patients who did not receive the genetic test, according to the Italian PHARMCLO trial, published March 11 in the Journal of the American College of Cardiology, in conjunction with the American College of Cardiology (ACC) 2018 Annual Scientific Session. Experts say the use of more potent antiplatelet drugs—prasugrel and ticagrelor—involves a fundamental trade-off between decreasing the risk of ischemia, but increasing the risk […]