A Rapid Real-Time PCR Assay for CYP2C19 Gene Variants with the use of Clopidogrel & Anti-Platelet Drugs PCI Stent Patients
Clopidogrel is an antiplatelet drug used to minimize the risk of heart failure and stroke in people at high risk. It is also used in heart attacks and after the insertion of a coronary artery stent (dual antiplatelet therapy) along with aspirin. It's mouth-taking. Effects start about two hours and last for five days
Clopidogrel is used to avoid heart attack and stroke in people at high risk for these conditions, including those with a history of myocardial infarction and other types of acute coronary syndrome, stroke, and peripheral artery disease.
- Present for treatment with a myocardial infarction with ST-elevation
- A dose of loading given before percutaneous coronary intervention (PCI), followed by a full year of treatment for those with vascular stent
- A loading dose given in advance of fibrinolytic therapy, continued for at least 14 days
- Including a loading dose and maintenance therapy in those receiving PCI and unable to tolerate aspirin therapy
The pharmacological effect of certain drugs in the body is dependent on many factors including mutations in drug target, drug transporters, and the metabolism of the drug in the body. The study of pharmacogenomics has vastly improved with research in the area of drug metabolizing enzymes closely followed by that in drug transporters and drug receptors. Such studies are important as it is thought that nearly 50% of the patients may not respond to the given drug due to polymorphisms in any of the above proteins
Providing the correct dose of any particular drug to a patient may depend on many factors that are both environmental as well as genetic. However, polymorphisms in the Cytochrome P450 family of enzymes (CYP2C9, CYP2C19 and CYP2D6 to name a few), cause changes in the metabolism of nearly 40% drugs.
Patients undergoing PCI procedure with coronary artery disease were offered the genetic test by the treating cardiologist for identifying the genotype of CYP2C19 gene. All patients were duly informed of the benefit of such a test and were asked to sign an informed consent form before blood collection. Ethical clearance was obtained from the Apollo Hospitals institutional ethics committee.
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