SHA24/019002

The Impact of CYP2C19 polymorphism on Platelet Reactivity for Guiding Clopidogrel Treatment and Cost Analysis

• CLASS IIb • 1. Genetic testing might be considered to identify whether a patient at high risk for poor clinical outcomes is predisposed to inadequate platelet inhibition with clopidogrel (829). (Level of Evidence: C)

• 2. When a patient predisposed to inadequate platelet inhibition with clopidogrel is identified by genetic testing, treatment with an alternate P2Y12 inhibitor (e.g., prasugrel or ticagrelor) might be considered (829). (Level of Evidence: C

Genetic Analysis

(P = 0.0002).

SNPs do impact clearly on PFT PFT may be prudent in some patients!

No mechanism to decide the best candidate!

Genotyping vs. PFT either can do!

Genotyping more informative!

US use the PFT as a cutoff for alternatives!

Outsource your Genetic testing for $$$$$