Pharmacogenetics and cardiovascular diseases

One of the most common drugs used to prevent heart attacks, strokes and other conditions caused by blood clots is clopidogrel. It is possible to test whether clopidogrel can prevent blood clots effectively in your body can be determined with a pharmacogenetic test.

Pharmacogenetics in the treatment of cardiovascular diseases

After a stroke, heart attack or percutaneous coronary intervention (PCI), the patient is usually prescribed with an antithrombotic medication to prevent blood clots. A common medication is clopidogrel (e.g. Plavix©), which is also used in the treatment of coronary artery disease (CAD) and transient ischemic attacks (TIA).

Unfortunately, clopidogrel cannot prevent thrombosis effectively in all patients. For clopidogrel to work properly, an enzyme called CYP2C19 is necessary. In about 30 % of people, this enzyme is missing or its production is lower than expected 1. For these patients, clopidogrel does not prevent blood clots as intended, and an alternative drug, such as prasugrel or ticagrelor, should be considered.

The European Society of Cardiology (ESC) recommends pharmacogenetic testing before prescribing clopidogrel if the patient has an elevated risk of blood clots or bleeding.2 ESC also highlights the importance of pharmacogenetic testing when prescribing warfarin and simvastatin.

[1] Häkkinen, K. et al. (2022). Implementation of CYP2D6 copy-number imputation panel and frequency of key pharmacogenetic variants in Finnish individuals with a psychotic disorder. The Pharmacogenomics Journal, 22(3), 166–172.
[2] Magavern, E. et al. (2022). The role of pharmacogenomics in contemporary cardiovascular therapy: a position statement from the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy. European Heart Journal-Cardiovascular Pharmacotherapy, 8(1), 85-99.

Benefits of pharmacogenetic testing

Reduces trial-and-error of medication optimisation

Faster medication and dose optimisation shortens treatment time

Reduces risk of adverse drug reactions

Supports medication decisions for the rest of your life