Why the study?
Recent guidelines recommend pharmacogenetic testing before clopidogrel prescription to identify CYP2C19 loss-of-function variants associated with reduced drug efficacy.
Does point-of-care CYP2C19 genotyping identify loss-of-function variants and alter management in patients with IS/TIA or requiring angioplasty?
Population
77 patients with IS/TIA on clopidogrel or requiring angioplasty at a tertiary stroke centre
Comparison
Point-of-care CYP2C19 genotyping using Genomadix Cube
Design
Pilot observational study
Follow-up
Three months
Key result
Point-of-care CYP2C19 genotyping identified loss-of-function variants in 26% of stroke or TIA patients, but demonstrated a 20% test failure rate that may reduce cost efficiency.
Authors
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Caution with empiric clopidogrel in ischaemic stroke; extends pharmacogenetic evidence into Level 1 European guidelines.
Observational (n=77)
No
Does point-of-care CYP2C19 genotyping identify loss-of-function variants and alter management in patients with IS/TIA or requiring angioplasty?
Point-of-care CYP2C19 genotyping in stroke patients successfully identifies clopidogrel resistance to guide alternative therapy, though high test failure rates present an implementation challenge.
Nicholas Wetherall (2026) conducted an observational in Ischaemic stroke or transient ischaemic attack (n=77). Point-of-care CYP2C19 genotyping was evaluated on CYP2C19 loss-of-function (LOF) variants (*2 or *3) prevalence. Point-of-care CYP2C19 genotyping identified loss-of-function variants in 26% of stroke or TIA patients, but demonstrated a 20% test failure rate that may reduce cost efficiency.