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Clopidogrel CYP2C19 Genotyping
Expected Turnaround Time
6 - 10 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Whole blood or LabCorp buccal swab kit (Buccal swab collection kit contains instructions for use of a buccal swab, PeopleSoft N° 3177.)
7 mL whole blood or LabCorp buccal swab kit
3 mL whole blood or two buccal swabs
Lavender-top (EDTA) tube, yellow-top (ACD) tube, or LabCorp buccal swab kit
Maintain specimen at room temperature or refrigerate at 4°C.
Causes for Rejection
Frozen or hemolyzed specimen; quantity not sufficient for analysis; one buccal swab; improper container; wet buccal swab
Clopidogrel is a prodrug that is metabolized to its active component by several cytochrome P450 proteins of which CYP2C19 plays a key role. Among clopidogrel treated patients, intermediate (IM) or poor (PM) metabolizers are associated with reduced platelet inhibition and an increased risk of cardiovascular complications, such as myocardial infarction, stroke, stent thrombosis, and/or death, as compared with normal (extensive) metabolizers. Intermediate to normal metabolizers (IM-EM) are anticipated to have a range of reduced to normal enzyme activity. Normal metabolizers (EM) are anticipated to have normal enzyme activity. Individuals who are carriers of the *17 allele are ultrarapid metabolizers (UM) and may have an enhanced response to clopidogrel. Ultrarapid metabolizers may be at increased risk of bleeding. Other common drugs metabolized by the 2C19 pathway include proton pump inhibitors (omeprazole), anticonvulsants (phenytoin and diazepam), and tricyclic antidepressants (amitriptyline and nortriptyline).
This assay does not detect other variants in the CYP2C19 gene that may affect metabolic activity.
The metabolism of drugs is also influenced by ethnicity, diet, and other medications. All factors should be considered prior to initiating new therapy. This testing does not rule out the possibility of variant alleles in other drug metabolism pathways.
DNA analysis of the Cytochrome P450 2C19 gene (OMIM 124020, 10q24.1-10q24.3) is performed using primer extension chemistry. Multiplex PCR amplifies DNA fragments containing the variants below. Primer extension then generates a biotin-labeled product to perform flow-sorted detection of both normal and variant sequences. Molecular-based testing is highly accurate, but as in any laboratory test, rare diagnostic errors may occur.
Alleles detected: *1,*2,*3,*17
*1 represents detection of the normal sequence for the variant sites tested.
|Order Code||Order Code Name||Order Loinc||Result Code||Result Code Name||UofM||Result LOINC|
|511710||Clopidogrel P450 2C19||504204||2C19 Genotype:||57132-3|
|511710||Clopidogrel P450 2C19||504205||2C19 Metabolic Activity:||79714-2|
|511710||Clopidogrel P450 2C19||504632||Director Review:||69426-5|
|511710||Clopidogrel P450 2C19||504379||Interpretation:||72879-0|
|511710||Clopidogrel P450 2C19||504380||CYP2C19 Information:||49549-9|
|511710||Clopidogrel P450 2C19||000000||MGRM Informed Consent Review||N/A|