Genetic Test Significantly Reduces Risk of Cardiovascular Events

The genetic testing allows physicians to pinpoint the best anti-clotting medication for each patient.

Decoding a patient's genetic tendencies is not just about rapid treatment as many patients take an anti-clotting drug for a year or longer. Patients who had the genetic deficiency and received an alternative medication were less likely to have a major adverse cardiovascular event compared with those who received clopidogrel during the follow-up period of up to a year.

A group of scientists led by those at the University of Florida Health (Jacksonville, FL, USA) analyzed medical outcomes in 1,815 patients who had genetic testing at the time of their cardiac procedure. The test identifies a genetic deficiency that affects the body's ability to activate clopidogrel, a common anti-clotting drug given after a coronary artery stent is inserted. The study examined the effect of genotype-guided treatment on cardiovascular outcomes after a heart procedure known as percutaneous coronary intervention, or PCI, in which a metallic stent is inserted into a heart artery to treat a blockage. More broadly, it shows the power and the promise of personalized medicine, which tailors medical decisions based on a patient's genetic information and other unique characteristics.

The study reported significant results as about 60% of patients with the genetic deficiency were given a different, more effective medication. Using the genetic data to guide changes in therapy reduced the percentage of deaths, heart attacks or strokes by nearly half compared with those who continued taking clopidogrel. Among those who had the genetic deficiency and continued taking clopidogrel, 8% of patients experienced one of those complications. About 30% of all patients have a genetic deficiency that impairs their ability to activate the drug, which can lead to decreased clopidogrel effectiveness and increased risk for adverse cardiovascular events such as strokes, heart attacks and death.

Dominick J. Angiolillo, MD, PhD, a cardiologist and professor of medicine, said, “This is an important breakthrough in personalized medicine because it shows how a genetic marker can be used to modify treatments and improve patient outcomes. There was prompt genotyping and the patients were quickly given the drug we thought would work best for them.” The study was presented at the American Heart Association's Scientific Sessions held November 12 to 16, 2016, in New Orleans. LA, USA.

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