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BioMed Research International
Volume 2013 (2013), Article ID 154073, 5 pages
http://dx.doi.org/10.1155/2013/154073
Research Article

Feasibility of a Microarray-Based Point-of-Care CYP2C19 Genotyping Test for Predicting Clopidogrel On-Treatment Platelet Reactivity

1Department of Laboratory Medicine, Bucheon St. Mary's Hospital, 2 Sosa-dong, Wonmi-gu, Gyeonggi-do, Bucheon-si 420-717, Republic of Korea
2Catholic Laboratory Development and Evaluation Center, College of Medicine, The Catholic University of Korea, Seoul 137-701, Republic of Korea
3Cardiovascular Center and Cardiology Division, Uijeongbu St. Mary’s Hospital, Uijeongbu 480-717, Republic of Korea
4Cardiovascular Center and Cardiology Division, Seoul St. Mary’s Hospital, 505 Banpo-dong, Seocho-gu, Seoul 137-701, Republic of Korea

Received 17 August 2012; Accepted 11 March 2013

Academic Editor: Yasemin Alanay

Copyright © 2013 Hyojin Chae et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Clopidogrel is a prodrug which is converted into active metabolite by cytochrome P450 isoenzyme, CYP2C19. Numerous polymorphisms of CYP2C19 are reported, and a strong link exists between loss-of-function (LOF) or gain-of-function polymorphisms, clopidogrel metabolism, and clinical outcome. Hence, a fully automated point-of-care CYP2C19 genotyping assay is more likely to bring personalized antiplatelet therapy into real practice. We assessed the feasibility of the Verigene 2C19/CBS Nucleic Acid Test, a fully automated microarray-based assay, compared to bidirectional sequencing, and performed VerifyNow P2Y12 assay to evaluate the effect of CYP2C19 polymorphisms on on-treatment platelet reactivity in 57 Korean patients treated with clopidogrel after percutaneous coronary intervention. The Verigene 2C19/CBS assay identified *2, *3, and *17 polymorphisms with 100% concordance to bidirectional sequencing in 180 minutes with little hands-on time. Patients were classified into 4 groups: extensive (*1/*1; , 21.1%), intermediate (*1/*2, *1/*3; , 57.9%), poor (*2/*2, *2/*3, and *3/*3; , 19.3%), and ultrarapid metabolizers (*1/*17; , 1.8%). The prevalence of the CYP2C19  *2, *3, and *17 alleles was 36.0%, 12.3%, and 0.9%. Platelet reactivity showed gene dose response according to the number of CYP2C19 LOF allele. In conclusion, the Verigene 2C19/CBS assay gave accurate CYP2C19 genotype results which were in well match with the differing on-treatment platelet reactivity.