Key result
Pre-emptive pharmacogenetic testing informs post-catheterization medication changes in ~20% of patients.
Why the study?
The projected impact of a multigene pharmacogenetic test on medication prescribing in cardiovascular patients undergoing cardiac catheterization was not established.
Cohort (n=122)
No
May support pre-emptive pharmacogenetic testing in cath patients; leaves open prospective outcome validation.
AIM: To determine the projected impact of a multigene pharmacogenetic (PGx) test on medication prescribing. MATERIALS & METHODS: A retrospective analysis was conducted with 122 cardiac catheterization laboratory patients undergoing angiography for eligibility of potential PGx-guided interventions that could have occurred if multigene PGx information was pre-emptively available at the time of the procedure. Medication data and presence of actionable at-risk genotypes were used to determine eligibility of a PGx intervention. RESULTS: 20% of the study population (n = 24) would have qualified for at least one PGx-based medication intervention per US FDA or Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines within 6 months of their cardiac catheterization procedure. Commonly encountered gene-drug pairs for these interventions included: CYP2C19 for clopidogrel and antidepressants, CYP2D6 for antidepressants and codeine, SLCO1B1 for simvastatin, and VKORC1/CYP2C9 for warfarin. CONCLUSION: Pre-emptive use of a multigene PGx test in the cardiac catheterization laboratory offers potential to reduce adverse medication outcomes.
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Dong et al. (2018) conducted a cohort in Coronary artery disease (undergoing nonemergent coronary angiography) (n=122). Pre-emptive availability of multigene pharmacogenetic (PGx) testing vs. Standard of care without pre-emptive PGx testing was evaluated on Number of cases where PGx information could have been utilized to optimize drug dosing or selection (qualifying for a PGx-based medication intervention per FDA or CPIC guidelines). In a retrospective cohort of cardiac catheterization patients, 20% (24 of 122) would have qualified for at least one pharmacogenetic-based medication intervention within 6 months if multigene testing was pre-emptively available.
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