Genetically assisting the use of Clopidogrel and Statin therapy.

Clopidogrel is an antiplatelet medication that is used to inhibit platelet activation and aggregation and is commonly prescribed after percutaneous coronary intervention (stent implantation) or stroke, to prevent secondary adverse cardiovascular events.

Unlike other antiplatelet agents (eg ticagrelor and prasugrel), clopidogrel is dependent on the liver enzyme CYP2C19 for activation.

Clopidogrel activation and effectiveness is reduced in patients who harbour loss-of-function variants in the CYP2C19 gene. Approximately 30-40% of patients carry these variants which leads to a reduced or absent CYP2C19 activity. Such individuals may not have sufficient active clopidogrel to inhibit platelet aggregation and may be at higher risk of a secondary adverse cardiovascular events.

In patients with loss-of-function CYP2C19, the FDA warn of a decreased clopidogrel effectiveness and recommend an alternate therapy.

Cardio-predict is a test that detects a wide range of commonly found loss-of-function CYP2C19 gene variants, thereby assisting clinicians select the most appropriate treatment for their patients.

Statin Therapy Guidance included in Cardio-predict

Many people are prescribed statin therapy to lower serum cholesterol levels. Genetic variants found in the gene SLCO1B1 can affect the way statins are transported to the liver where they are metabolised and removed from the body. These variants lead to a reduced function resulting in elevated statin blood levels, thereby increasing the risk of muscle pain or weakness.

Individuals who carry the SCLO1B1 gene variant and who are prescribed certain statins may discontinue their use due to the onset of muscle pain. Cardio-predict can identify such individuals at risk of muscle pain who can be prescribed an alternate therapy.