Clopidogrel Response (CYP2C19) Genotype Test (830) (Add-on)

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Category:

CPT Code:

81225

Test Type: Whole Blood Kit Based
Stability Time:

Stability

Refrigerated:  15 days

Reference Range:
  • Normal Clopidogrel Metabolizers
    • Genotype *1/*1
    • Genotype *2/*17 (metabolism is not known but is assumed to fall in the normal category)
    • Genotype *3/*17 (metabolism is not known but is assumed to fall in the normal category)
  • Increased Clopidogrel Metabolizer
    • Genotype *1/*17
  • Decreased Clopidogrel Metabolizers
    • Genotype *1/*2
    • Genotype *1/*3
  • Markedly Increased Clopidogrel Metabolizer
    • Genotype *17/*17
  • Markedly Decreased Clopidogrel Metabolizers
    • Genotype *17/*17
    • Genotype *2/*2
    • Genotype *3/*3
    • Genotype *2/*3

 

*2/*17, *3/*17 metabolism is not known but is assumed to fall in the normal category

Overview:

CYP2C19 polymorphisms are inherited variations in the DNA sequence of the gene that codes for the cytochrome P450 (CYP) enzyme 2C19. This enzyme is found in the liver and converts the pro-drug clopidogrel (PLAVIX®) to its active form.

Knowing the CYP2C19 genotype is important prior to angioplasty to assure proper treatment with clopidogrel or prasugrel to prevent the complications of either stent closure or significant bleeding. The intended use of CYP2C19 testing is as an aid in treatment decisions related to the dosage of clopidogrel (Plavix). The genetic test identifies individuals that have reduced metabolism of clopidogrel, thus requiring higher amounts of the drug in order to reach an efficacious dose of the active agent, or sometimes require a different agent such as prasurgrel or ticagrelor, because they do not metabolize clopidogrel to its active form at all. Moreover, there is another group of patients identified by this testing who has increased metabolism of clopidogrel to its active form, and such patients require a decreased dose of clopidogrel to prevent bleeding complications.

Methodology - Real-time polymerase chain reaction (PCR)

Collection Details:

Collection Instructions:

Preferred Specimen

1.0 mL whole blood collected in EDTA (Lavender Top)

Transport Temperature

Refrigerated (ship on frozen cold packs)