Gene testing in response to treatment with Clopidogrel in cardiovascular interventions

Article by Dr. Ly Thi Thanh Ha - Medical Genetics Division, Vinmec High-Tech Center.

Clopidogrel is an antiplatelet agent, which reduces the risk of myocardial infarction and stroke in patients with acute coronary syndromes, and in patients with atherosclerotic vascular disease. Clopidogrel is also indicated in combination with aspirin in patients undergoing percutaneous coronary intervention (PCI), eg, stenting.

1.Clopidorgel - intended use?

Clopidogrel belongs to the group of cardiovascular drugs, is indicated for the treatment of some subjects in the following cases:
Treatment and prevention of heart attack, cerebral ischemia, prevention of stroke, reduction of the risk of myocardial infarction for patients. patients with acute coronary syndromes Unstable angina Heart rhythm disturbances or blood easily stagnates in the heart and forms blood clots Peripheral artery disease Support for treatment after cardiovascular surgery Plaque rupture Atherosclerosis in the coronary arteries leads to the formation of platelet thrombus that causes embolism which can cause acute coronary syndrome. Antiplatelet therapy (aspirin, clopidogrel...) plays an essential role in the prevention and treatment of acute coronary syndromes.

2.CYP2C19 . Genotyping Test

Bảng ví dụ về mối tương quan giữa kiểu gen, kiểu hình và liều điều trị cho từng cá thể

Clopidogrel is an inactive prodrug. To become active antiplatelet agents, they must be metabolized in the liver via the cytochrome P450 system (mainly CYP2C19). The metabolic activity of the CY2C19 gene affects the effectiveness of clopidogrel. Based on the CYP2C19 genotype, the degree of metabolism of Clopidogrel drug is divided into 3 levels: low metabolizers, intermediate metabolizers and normal metabolizers and rapid metabolizers. ) . Depending on the level of drug metabolism of each individual, it will be necessary to adjust the dose of the treatment drug accordingly.
The CYP2C19 genotyping test has been performed routinely at the Medical Genetics Division, High-Tech Center, Vinmec International General Hospital.

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