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. 2013 Jun;101(6):313-7.
doi: 10.1016/j.ygeno.2013.01.005. Epub 2013 Feb 24.

Mutational analysis clopidogrel resistance and platelet function in patients scheduled for coronary artery bypass grafting

Mick Correll  1 , Christopher K Johnson, Giovanni Ferrari, Mariano Brizzio, Andrew W C Mak, John Quackenbush, Richard E Shaw, Alex Zapolanski, Juan B Grau
Affiliations

Mutational analysis clopidogrel resistance and platelet function in patients scheduled for coronary artery bypass grafting

Mick Correll et al. Genomics. 2013 Jun.

Abstract

Clopidogrel is an oral antiplatelet pro-drug prescribed to 40 million patients worldwide who are at risk for thrombotic events or receiving percutaneous coronary intervention (PCI). However about a fifth of patients treated with clopidogrel do not respond adequately to the drug. From a cohort of 105 patients on whom we had functional data on clopidogrel response, we used ultra-high throughput sequencing to assay mutations in CYP2C19 and ABCB1, the two genes genetically linked to respond. Testing for mutations in CYP2C19, as recommended by the FDA, only correctly predicted if a patient would respond to clopidogrel 52.4% of the time. Similarly, testing of the ABCB1 gene only correctly foretold response in 51 (48.6%) patients. These results are clinically relevant and suggest that until additional genetic factors are discovered that predict response more completely, functional assays are more appropriate for clinical use.

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