Point of care CYP2C19 genotyping after percutaneous coronary intervention

Linnea Baudhuin, Laura J. Train, Shaun G. Goodman, Gary E. Lane, Ryan J. Lennon, Verghese Mathew, Vishakantha Murthy, Tamim M. Nazif, Derek Y.F. So, John P. Sweeney, Alan H.B. Wu, Charanjit S. Rihal, Michael E. Farkouh, Naveen Luke Pereira

Research output: Contribution to journalReview articlepeer-review

Abstract

Loss-of-function CYP2C19 variants are associated with increased cumulative ischemic outcomes warranting CYP2C19 genotyping prior to clopidogrel administration. TAILOR-PCI was an international, multicenter (40 sites), prospective, randomized trial comparing rapid point of care (POC) genotype-guided vs. conventional anti-platelet therapy. The performance of buccal-based rapid CYP2C19 genotyping performed by non-laboratory-trained staff in TAILOR-PCI was assessed. Pre-trial training and evaluation involved rapid genotyping of 373 oral samples, with 99.5% (371/373) concordance with Sanger sequencing. During TAILOR-PCI, 5302 patients undergoing PCI were randomized to POC rapid CYP2C19 *2, *3, and *17 genotyping versus no genotyping. At 12 months post-PCI, TaqMan genotyping determined 99.1% (2,364/2,385) concordance with the POC results, with 90.7–98.8% sensitivity and 99.2–99.6% specificity. In conclusion, non-laboratory personnel can be successfully trained for on-site instrument operation and POC rapid genotyping with analytical accuracy and precision across multiple international centers, thereby supporting POC genotyping in patient-care settings, such as the cardiac catheterization laboratory. Clinical Trial Registration: https://www.clinicalTrials.gov (Identifier: NCT01742117).

Original languageEnglish (US)
JournalPharmacogenomics Journal
DOIs
StateAccepted/In press - 2022

ASJC Scopus subject areas

  • Molecular Medicine
  • Genetics
  • Pharmacology

Fingerprint

Dive into the research topics of 'Point of care CYP2C19 genotyping after percutaneous coronary intervention'. Together they form a unique fingerprint.

Cite this