CYP2C9 & CYP2C19 & ABCB1
The test is based on pharmacogenomics and determines the potential of clopidogrel variation in the patient, the possibility of thrombosis after its administration and the appropriate dosage in each case. Clopidogrel is a medicinal substance with antithrombotic action. Despite the clinical benefit achieved by administering clopidogrel to patients with cardiovascular disorders, a significant number of patients still experience cardiovascular events with stent or graft thrombosis following coronary artery by-pass.
Among the genetic factors, the gene polymorphisms of CYP2C9, CYP2C19 and ABCB1 significantly affect the pharmacokinetic and pharmacodynamic properties of clopidogrel.
Polymorphisms in CYPs genes that cause reduced enzyme activity result in lower plasma levels of the active metabolite of clopidogrel and less inhibition of platelets.
Therefore, there is a higher risk of a new thrombotic event following an Acute Coronary Syndrome-ACS, or a Percutaneous Coronary Intervention (PCI). In addition, the C3435T polymorphism in the ABCB1 gene has been associated with reduced absorption of the drug from the intestine reducing its antiplatelet activity.
On the contrary, in subjects with the CYP2C19*17 allele, which is associated with increased enzyme activity, clopidogrel exhibits enhanced protective activity against the development of thrombosis and increased inhibition of P2Y12, thus increased bleeding risk.
Therefore, it is important to know the possibility of clopidogrel variation in each patient, and the appropriate dosage for the best possible management.
The test is performed on 1 EDTA vial of blood or saliva sample