Rapid point-of-care CYP2C19*2 genotyping to personalise antiplatelet therapy in patients undergoing coronary stenting

Abstract

A poster presentation regarding rapid point-of-care CYP2C19*2 genotyping to personalise antiplatelet therapy in patients undergoing coronary stenting. Background: The CYP2C19 loss-of-function (LoF) *2 variant allele impairs clopidogrel bioactivation and increases the risk of thrombotic complications after coronary stenting due to decreased response to clopidogrel. Since about 50% of major adverse cardiac events occur within the first two days after coronary stenting, a rapid CYP2C19*2 genotype result is important to individualise antiplatelet therapy at the start of treatment. Guidelines for CYP2C19 genotype and clopidogrel therapy recommend that *2 allele carriers should be prescribed an alternative antiplatelet agent to clopidogrel, such as prasugrel or ticagrelor, provided there is no contra-indication. Aim: To apply a pharmacist-led process to personalise antiplatelet therapy guided by CYP2C19*2 genotype in patients undergoing coronary stenting using a rapid point-of-care (POC) genotyping system.