| Title |
Clinical implementation of rapid CYP2C19 genotyping to guide antiplatelet therapy after percutaneous coronary intervention
|
|---|---|
| Published in |
Journal of Translational Medicine, April 2018
|
| DOI | 10.1186/s12967-018-1469-8 |
| Pubmed ID | |
| Authors |
Larisa H. Cavallari, Francesco Franchi, Fabiana Rollini, Latonya Been, Andrea Rivas, Malhar Agarwal, D. Max Smith, Kimberly Newsom, Yan Gong, Amanda R. Elsey, Petr Starostik, Julie A. Johnson, Dominick J. Angiolillo |
| Abstract |
The CYP2C19 nonfunctional genotype reduces clopidogrel effectiveness after percutaneous coronary intervention (PCI). Following clinical implementation of CYP2C19 genotyping at University Florida (UF) Health Shands Hospital in 2012, where genotype results are available approximately 3 days after PCI, testing was expanded to UF Health Jacksonville in 2016 utilizing a rapid genotyping approach. We describe metrics with this latter implementation. Patients at UF Health Jacksonville undergoing left heart catheterization with intent to undergo PCI were targeted for genotyping using the Spartan RX™ system. Testing metrics and provider acceptance of testing and response to genotype results were examined, as was antiplatelet therapy over the 6 months following genotyping. In the first year, 931 patients, including 392/505 (78%) total patients undergoing PCI, were genotyped. The median genotype test turnaround time was 96 min. Genotype results were available for 388 (99%) PCI patients prior to discharge. Of 336 genotyped PCI patients alive at discharge and not enrolled in an antiplatelet therapy trial, 1/6 (17%) poor metabolizers (PMs, with two nonfunctional alleles), 38/93 (41%) intermediate metabolizers (IMs, with one nonfunctional allele), and 119/237 (50%) patients without a nonfunctional allele were prescribed clopidogrel (p = 0.110). Clopidogrel use was higher among non-ACS versus ACS patients (78.6% vs. 42.2%, p < 0.001). Six months later, among patients with follow-up data, clopidogrel was prescribed in 0/4 (0%) PMs, 33/65 (51%) IMs, and 115/182 (63%) patients without a nonfunctional allele (p = 0.008 across groups; p = 0.020 for PMs versus those without a nonfunctional allele). These data demonstrate that rapid genotyping is clinically feasible at a high volume cardiac catheterization facility and allows informed chronic antiplatelet prescribing, with lower clopidogrel use in PMs at 6 months. Trial registration ClinicalTrials.gov Identifier: NCT02724319; registered March 31, 2016; https://www.clinicaltrials.gov/ct2/show/NCT02724319?term=angiolillo&rank=7. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 37 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 37 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 7 | 19% |
| Researcher | 6 | 16% |
| Student > Doctoral Student | 3 | 8% |
| Student > Bachelor | 3 | 8% |
| Lecturer | 2 | 5% |
| Other | 6 | 16% |
| Unknown | 10 | 27% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 9 | 24% |
| Pharmacology, Toxicology and Pharmaceutical Science | 6 | 16% |
| Biochemistry, Genetics and Molecular Biology | 2 | 5% |
| Unspecified | 1 | 3% |
| Business, Management and Accounting | 1 | 3% |
| Other | 5 | 14% |
| Unknown | 13 | 35% |
Attention Score in Context
This research output has an Altmetric Attention Score of 14. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 July 2022.
All research outputs
#2,249,854
of 22,842,950 outputs
Outputs from Journal of Translational Medicine
#364
of 3,995 outputs
Outputs of similar age
#50,977
of 328,418 outputs
Outputs of similar age from Journal of Translational Medicine
#11
of 103 outputs
Altmetric has tracked 22,842,950 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 90th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,995 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.5. This one has done particularly well, scoring higher than 90% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 328,418 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 84% of its contemporaries.
We're also able to compare this research output to 103 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 89% of its contemporaries.