OTTAWA, Nov. 9, 2011 /CNW/ - Tailored anti-platelet therapy, made possible through a novel
point-of-care genetic test, optimizes treatment for patients who carry
a common genetic variant, researchers at the University of Ottawa Heart
Institute (UOHI) have found.
A UOHI clinical trial known as RAPID GENE studied 200 patients
undergoing coronary stent implantation for acute coronary syndrome or
stable angina. Use of a simple, saliva swab test performed by nurses at
the bedside on half of the patients allowed doctors to almost instantly
identify those with the genetic variant, known as CYP2C19*2, which puts them at risk of reacting poorly to standard anti-platelet
drug therapy, and administer an alternative drug.
The study demonstrated that tailored drug treatment therapy made
possible by the genetic testing successfully protected all of the
patients with the at-risk genetic variant from subsequent adverse
events, while 30 per cent of patients treated with standard therapy did
not receive adequate protection.
"These results are extremely promising, not only in the field of
cardiology but for all areas of medicine. If you can administer a
simple, rapid genetic test at the bedside, doctors can prescribe the
right drug to the right patient at the right time. We then have a much
greater chance of improving health outcomes and providing cost savings
for the health care system," said Dr. Derek So, lead researcher for the
study and Staff Interventional Cardiologist and Assistant Professor at
the University of Ottawa Heart Institute.
About 25 per cent of Caucasians and up to 40 per cent of Asians have the
genetic variant CYP2C19*2, which puts a patient at risk of not responding well to clopidogrel
(Plavix), the standard anti-platelet drug given following stent
procedures. Those tested who were found to carry the at-risk genetic
variant were administered an alternative drug, prasugrel (Effient).
About half of the patients were randomly selected to undergo the bedside
genetic testing. This was compared to a group receiving conventional
treatment without genetic testing.
"The RAPID GENE trial shows that point-of-care genetic testing is
clinically feasible and accurate, and facilitates rapid personalization
of anti-platelet therapy. A pharmacogenetic approach to treatment
carries the potential to maximize treatment efficacy, while
simultaneously minimizing harm to patients," stated Dr. Jason Roberts,
the co-Principal Investigator of RAPID GENE and Resident Physician at
The clinical trial findings were presented today by Dr. So as a
late-breaking clinical trial at the Transcatheter Cardiovascular
Therapeutics 2011 conference - the world's largest forum for
interventional cardiovascular medicine, which showcases the latest
advances in current therapies and clinical research.
Traditionally, genetic testing to gain this kind of patient knowledge
takes anywhere between five to seven days. The rapid nature of this
first bedside test allows doctors to react much more quickly to make
effective decisions about treatment.
The point-of-care genetic test used in the study is a first in medicine
and overcame many of the previous obstacles that had prevented routine
clinical genetic testing. The test featured:
A saliva swab performed by clinical nurses at the bedside with no prior
training in genetic laboratory techniques.
A one-step insertion of the swab into a testing machine.
Sixty minutes to identify whether individuals carried the at-risk
The University of Ottawa Heart Institute is Canada's largest and
foremost cardiovascular health centre dedicated to understanding,
treating and preventing heart disease. We deliver high-tech care with a
personal touch, shape the way cardiovascular medicine is practiced, and
revolutionize cardiac treatment and understanding. We build knowledge
through research and translate discoveries into advanced care. We serve
the local, national and international community, and are pioneering a
new era in heart health.
The University of Ottawa Heart Institute is a leader in understanding
the genetics of heart disease - the next major frontier for
cardiovascular medicine. We are home to the John & Jennifer Ruddy
Canadian Cardiovascular Genetics Centre, the first comprehensive Centre
of its kind dedicated to both the research and clinical management of
inherited cardiovascular disease in Canada. The Centre identified the
strongest genetic risk factor for coronary artery disease and heart
attack found to date (the 9p21 locus). The Centre is home to the
Genetic Analysis Core Facility which provides specialized equipment and
technical expertise to researchers throughout the University of Ottawa
For more information, visit www.ottawaheart.ca
SOURCE OTTAWA HEART INSTITUTE, UNIVERSITY OF OTTAWA
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