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."
Find out more here.