Comparison of Two Point-of-Care CYP2C19 Genotyping Assays for Genotype-Guided Antiplatelet Therapy

Related Experiment Video

Updated: Feb 16, 2026

A Method to Study the C924T Polymorphism of the Thromboxane A2 Receptor Gene
07:00

A Method to Study the C924T Polymorphism of the Thromboxane A2 Receptor Gene

Published on: April 1, 2019

10.4K

Yaolin Zhou1, Alicia R Armstead1, Gina M Coshatt1

  • 1Department of Pathology, University of Alabama at Birmingham, Birmingham AL, USA.

Annals of Clinical and Laboratory Science
|December 22, 2017
PubMed

Insights

Point-of-care CYP2C19 genotyping is crucial for clopidogrel therapy. The Spartan RX system offers accurate and rapid results for patients undergoing percutaneous coronary intervention, unlike the Verigene test which had a high no-call rate.

Area of Science:

  • Pharmacogenomics
  • Clinical Diagnostics
  • Cardiovascular Medicine

Background:

  • CYP2C19 genetic variations significantly impact clopidogrel's antiplatelet efficacy, affecting approximately 12% of treatment variability.
  • Patients undergoing percutaneous coronary intervention (PCI) often require clopidogrel, making rapid CYP2C19 genotyping critical for personalized therapy.

Purpose of the Study:

  • To validate and compare the performance of two point-of-care CYP2C19 genotyping tests: Nanosphere Verigene and Spartan RX.
  • To assess the clinical utility of rapid CYP2C19 genotyping in guiding treatment decisions for post-PCI patients.

Main Methods:

  • A CLIA-certified laboratory performed 99 Verigene and 108 Spartan RX CYP2C19 assays.
  • Performance metrics including accuracy, no-call rates, and turnaround times were compared between the two platforms.
  • A new clinical workflow utilizing the Spartan RX assay was implemented for post-PCI patients.

Main Results:

  • Both assays demonstrated 100% accuracy when results were generated.
  • The Verigene CYP2C19 assay exhibited a 33% no-call rate, whereas the Spartan RX system provided consistent results.
  • The Spartan RX assay, integrated into a new workflow, delivered clinically significant results to physicians within one hour for 342 post-PCI patients.

Conclusions:

  • The Spartan RX CYP2C19 test provides accurate and rapid point-of-care genotyping results, essential for acute cardiac care workflows.
  • Implementation of the Spartan RX system facilitates timely clinical decision-making for patients requiring clopidogrel therapy.
  • Ongoing prospective studies aim to evaluate the long-term outcomes and effectiveness of CYP2C19 testing in this patient population.
Abstract

More Related Videos

Microfluidics in Assessing Platelet Function06:47

Microfluidics in Assessing Platelet Function

Published on: November 8, 2024

1.7K
An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings19:57

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings

Published on: March 30, 2014

19.4K

Related Concept Videos

Pharmacogenetics of Phase I Enzymes: Cytochrome P450 Isozymes01:28

Pharmacogenetics of Phase I Enzymes: Cytochrome P450 Isozymes

Cytochrome P450 (CYP450) enzymes are a superfamily of heme-containing monooxygenases that play a pivotal role in Phase I drug metabolism by catalyzing oxidation and reduction reactions.These enzymes transform lipophilic xenobiotics into more hydrophilic metabolites, facilitating subsequent Phase II conjugation and eventual excretion. The CYP450 family is classified into families (e.g., CYP1–CYP3) and subfamilies (e.g., CYP2A, CYP2C), based on amino acid sequence homology.CYP450...
9
Pharmacogenomics: Identification of New Drug Targets01:29

Pharmacogenomics: Identification of New Drug Targets

Advances in genomics have profoundly influenced drug discovery by increasing both the speed and accuracy of pharmaceutical development. Pharmacogenomics, which examines how genetic variation influences drug response, facilitates the identification of novel therapeutic targets and enables patient stratification for personalized treatment. These strategies contribute to improved drug efficacy, minimized adverse effects, and more efficient clinical trial design.Mapping genetic differences...
9
Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu01:29

Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu

Genetic variations significantly influence drug response through pharmacokinetics, receptor interactions, and biologic milieu modifications. Pharmacokinetic alterations impact drug metabolism and clearance, affecting efficacy and toxicity. Variants in drug-metabolizing enzymes, such as CYP2C9 and CYP2C19, alter drug activation and elimination. For example, CYP2C9 loss-of-function variants require lower warfarin doses to prevent excessive bleeding, while CYP2C19 variants reduce clopidogrel...
10
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
1.3K
Pharmacogenetics of Drug Metabolism: Overview01:27

Pharmacogenetics of Drug Metabolism: Overview

Genetic polymorphism in drug metabolism is crucial to the inter-individual variability observed in drug responses. Drug metabolism primarily involves the chemical modification of drugs and other xenobiotics to enhance their elimination by increasing their polarity. Two main classes of enzymes mediate this biotransformation process: Phase I enzymes, primarily cytochrome P450s, catalyze oxidation and reduction reactions, while other enzymes, such as esterases, mediate hydrolysis, and Phase II...
15
Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase01:11

Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase

Genetic polymorphisms in drug targets have emerged as critical determinants of interindividual variability in drug response and toxicity. Pharmacogenomic investigations increasingly focus on identifying these variations to personalize and optimize therapeutic interventions. A drug target may be a receptor, enzyme, or signaling protein involved in pharmacologic responses or disease-related pathways. While early pharmacogenetic studies focused primarily on drug metabolism, current research...
15