Featured Research

from universities, journals, and other organizations

Genomics of antiplatelet heart medication being studied

Date:
November 13, 2013
Source:
Mayo Clinic
Summary:
Which antiplatelet medication is best after a coronary stent? The costly and potential life-or-death question lingers after most of the 600,000 angioplasties performed every year in the United States. The answer may lie in your genes, but professional cardiovascular societies and many working cardiologists question the U.S. Food and Drug Administration’s recent recommendation that patients undergo genetic testing before taking Plavix (clopidogrel bisulfate).

Which antiplatelet medication is best after a coronary stent? The costly and potential life-or-death question lingers after most of the 600,000 angioplasties performed every year in the United States. The answer may lie in your genes, but professional cardiovascular societies and many working cardiologists question the U.S. Food and Drug Administration's recent recommendation that patients undergo genetic testing before taking Plavix (clopidogrel bisulfate).

The Tailored Antiplatelet Therapy to Lessen Outcomes after Percutaneous Coronary Intervention (TAILOR-PCI) Study, launched this summer by the Center for Individualized Medicine and the Division of Cardiovascular Diseases at Mayo Clinic, examines whether prescribing heart medication based on a patient's CYP2C19 genotype will help prevent heart attack, stroke, unstable angina, and cardiovascular death in patients who undergo percutaneous coronary intervention, commonly called angioplasty.

"The current standard of care after angioplasty is to prescribe clopidogrel for one year, regardless of a person's individual genotype, even though we have known for several years that variation in the CYP2C19 gene may diminish the benefit from the drug," says Naveen Pereira, M.D., a Mayo Clinic cardiologist and principal investigator of TAILOR-PCI. "What we don't know -- and why there is such confusion in the cardiovascular community -- is how these genetic changes affect long-term clinical outcomes and whether we can decrease overall health care costs."

Antiplatelet medication reduces the risk of heart attack, unstable angina, stroke and cardiovascular death after stent placement by reducing the possibility of blood clots around the surgical site.

Plavix, however, remains ineffective until the liver enzyme CYP2C19 metabolizes the drug into its active form. Some alternative medications, including Brilinta (ticagrelor), do not require activation through the same genetic pathway.

"Ticagrelor has its own risks, including serious or life-threatening bleeding. Additionally, this alternative therapy costs approximately six to eight times as much and must be taken twice a day," says Dr. Pereira. "Ultimately, what we're trying to do with TAILOR is use pharmacogenomics to determine whether choosing medication based on individual genotype will help patients live longer and whether the benefits will outweigh the risks of alternative therapies."

Nilay Shah, Ph.D., a Mayo Clinic Health Sciences Research professor, will study potential cost impacts to the health care system.

"This study examines as much as an $8 billion question in health care," says Dr. Shah. "Clopidogrel is the second-most prescribed medication in the United States; and although ticagrelor costs much more, the costs of taking patients into the emergency room and performing a second angioplasty are much higher."

Another additional benefit of the study will be creation of a coronary artery disease biobank containing DNA samples from the study's 5,300 participants. Researchers at Mayo Clinic and elsewhere can mine these samples and use genomic sequencing technologies to help further medicine's understanding of the origins of and risk factors for coronary heart disease.

Gianrico Farrugia, M.D., director of the Center for Individualized Medicine, says, "TAILOR-PCI is exactly the type of research we do every day -- the kind that translates into better health for our patients and improves the delivery of care for millions of patients around the world."

Heart disease is the No. 1 killer of men and women in the United States, and up to one-third of patients currently taking Plavix (up to half of some Asian populations) have a genomic variant implicated in diminished drug response. Study teams at 15 hospitals in three countries have teamed up to enroll 5,300 patients into TAILOR-PCI and deliver results in three years.


Story Source:

The above story is based on materials provided by Mayo Clinic. Note: Materials may be edited for content and length.


Cite This Page:

Mayo Clinic. "Genomics of antiplatelet heart medication being studied." ScienceDaily. ScienceDaily, 13 November 2013. <www.sciencedaily.com/releases/2013/11/131113132137.htm>.
Mayo Clinic. (2013, November 13). Genomics of antiplatelet heart medication being studied. ScienceDaily. Retrieved July 24, 2014 from www.sciencedaily.com/releases/2013/11/131113132137.htm
Mayo Clinic. "Genomics of antiplatelet heart medication being studied." ScienceDaily. www.sciencedaily.com/releases/2013/11/131113132137.htm (accessed July 24, 2014).

Share This




More Health & Medicine News

Thursday, July 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

New Painkiller Designed To Discourage Abuse: Will It Work?

New Painkiller Designed To Discourage Abuse: Will It Work?

Newsy (July 24, 2014) The FDA approved Targiniq ER on Wednesday, a painkiller designed to keep users from abusing it. Like any new medication, however, it has doubters. Video provided by Newsy
Powered by NewsLook.com
Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Newsy (July 24, 2014) Sheik Umar Khan has treated many of the people infected in the Ebola outbreak, and now he's become one of them. Video provided by Newsy
Powered by NewsLook.com
Condemned Man's US Execution Takes Nearly Two Hours

Condemned Man's US Execution Takes Nearly Two Hours

AFP (July 24, 2014) America's death penalty debate raged Thursday after it took nearly two hours for Arizona to execute a prisoner who lost a Supreme Court battle challenging the experimental lethal drug cocktail. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com
China's Ageing Millions Look Forward to Bleak Future

China's Ageing Millions Look Forward to Bleak Future

AFP (July 24, 2014) China's elderly population is expanding so quickly that children struggle to look after them, pushing them to do something unexpected in Chinese society- move their parents into a nursing home. Duration: 02:07 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins