GENETIC TESTING TO SUPPORT ANTITHROMBOTIC TREATMENT

Gene testing in antithrombotic therapy is the VKORC1, YP2C9, CYP2C19 genotyping test to assist doctors in predicting response to antiplatelet drugs (Clopidogrel) or anticoagulants vitamin K (AVK).

The value of the test:

• Determine the appropriate dose for the patient
• Individualization of treatment reduces the risk of bleeding and the risk of embolism.

• Clopidogrel is an antiplatelet drug that exists as a prodrug, which is metabolized by the liver to the active form, in which the predominant enzyme is CYP2C19. Clopidogrel resistance is a condition in which patients have a poor response to the drug. These patients are at increased risk for subsequent clinical events including stent re-occlusion, recurrent myocardial infarction, and death.
• AVK is an oral anticoagulant that belongs to the vitamin K antagonist group. AVK has a narrow therapeutic range and often requires dose adjustment to reduce the risk of thrombosis or bleeding. The drug is metabolised by CYP2C9 and VKORC1 enzymes. Genotyping will help determine the starting dose of AVK.

• DNA extraction.
• Amplify gene regions containing variants on 2 genes VKORC1 and CYP2C19 by PCR technique.
• Gene sequencing on the automatic gene sequencing system ABI3130xl (USA).

GENTIS is a pioneer in gene testing in Vietnam, with current technology and equipment. Identify variants of CYP2C19*2 (681G>A) and CYP2C19*3 (636G>A)

• Identification of -1639G>A variants on VKORC1 gene and variants of CYP2C9*2 (430C>T) and CYP2C9*3 (1075A>C)
• Time to return results: from 2 days
• Samples: 1 – 3 ml of whole blood contained in an EDTA anticoagulation tube
• Technology used: Sequencing regions carrying variants on 2 genes VKORC1 and CYP2C19