Projected impact of pharmacogenomic testing on medications beyond antiplatelet therapy in percutaneous coronary intervention patients.
Rachel M BlackAlexis K WilliamsLindsay RatnerDaniel J CronaTim WiltshireKaren E WeckGeorge A StoufferAnd Craig R LeePublished in: Pharmacogenomics (2020)
Aim: CYP2C19 genotyping is used to guide antiplatelet therapy after percutaneous coronary intervention (PCI). This study evaluated the potential impact of CYP2C19 and multigene pharmacogenomics (PGx) testing on medications beyond antiplatelet therapy in a real-world cohort of PCI patients that underwent CYP2C19 testing. Methodology & results: Multiple medications with actionable PGx recommendations, including proton pump inhibitors, antidepressants and opioids, were commonly prescribed. Approximately 50% received a CYP2C19 metabolized medication beyond clopidogrel and 7% met criteria for a CYP2C19 genotype-guided intervention. A simulation analysis projected that 17.5 PGx-guided medication interventions per 100 PCI patients could have been made if multigene PGx results were available. Conclusion: This suggests that CYP2C19 and multigene PGx results could be used to optimize medication prescribing beyond antiplatelet therapy in PCI patients.
Keyphrases
- emergency department
- antiplatelet therapy
- percutaneous coronary intervention
- acute coronary syndrome
- st segment elevation myocardial infarction
- end stage renal disease
- acute myocardial infarction
- coronary artery disease
- st elevation myocardial infarction
- chronic kidney disease
- newly diagnosed
- ejection fraction
- peritoneal dialysis
- coronary artery bypass grafting
- randomized controlled trial
- primary care
- atrial fibrillation
- prognostic factors
- heart failure
- major depressive disorder
- climate change
- left ventricular
- high throughput
- gene expression
- drug induced