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RAPID GENE shows utility of bedside genetic testing

31 Jul, 12 | by Alistair Lindsay

The CYP2C19*2 allele is a common genetic variant that has been associated with a significantly increased risk of major cardiovascular events and stent thrombosis following percutaneous coronary intervention (PCI).  In this study a novel point-of-care genetic test was used to identify carriers of the CYP2C19*2 allele and to tailor a pharmacogenetic appriach to dual antiplatelet treatment after PCI. more…

Bedside genetic test identifies non-responders to Clopidogrel

25 Apr, 12 | by Alistair Lindsay

Clopidogrel is an inactive prodrug that requires hepatic bioactivation via several cytochrome P450 enzymes, including CYP2C19. A number of different alleles of CYP2C19 have been identified; depending on the allele present the enzymatic activity of CYP2C19 can be normal, or reduced. more…

Interleukin-6 and heart disease

11 Apr, 12 | by Alistair Lindsay

Known vascular risk factors can explain only about half of all cardiovascular disease, leaving much to be discovered about other causes of stroke and heart attack. Persistent inflammation has been implicated in the pathogenesis of coronary heart disease, but causality has not been established for any specific inflammatory mediator. more…

Genetic factors related to early stent thrombosis

22 Nov, 11 | by Alistair Lindsay

Dual anti-platelet therapy (DAPT) reduces cardiovascular events after PCI by more than 80%.  However, stent thrombosis can occur in 0.5% to 4% of patients within the first year following PCI, with the majority occurring in the first month.  Cayla et al. performed a case-control study using a candidate gene approach – looking in particular at genetic variations previously associated with clopidogrel pharmocogenetics and arterial thrombosis – in order to determine their impact on early stent thrombosis, in addition to established clinical and angiographic factors. more…

Genetic polymorphisms and response to clopidogrel and risk of cardiovascular events

15 Feb, 09 | by Alistair Lindsay

Across the whole spectrum of acute coronary syndromes and in patients undergoing PCI and stenting, dual anti-platelet therapy with aspirin and clopidogrel is the current recognised standard of care. However, significant variation in response to clopidogrel is observed between patients, with those with lesser degrees of platelet inhibition being at higher risk of adverse cardiovascular events.  Two studies in the New England Journal of Medicine investigate the possible reasons for this. more…

SEARCHing For A Genetic Cause of Statin Myopathy

7 Oct, 08 | by Alistair Lindsay

The incidence of myopathy secondary to statin use is approximately 1 in 10,000 patients/year on standard doses, but increases with higher doses or concurrent prescription of drugs such as cyclosporine that can inhibit statin metabolism.  Identification of genetic factors that influence an individual’s susceptibility to these complications would improve patient management by identifying those who should take a modified dose or perhaps even avoid a certain agent. more…

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