Patient genetic testing helpful when selecting blood thinner, Mayo study suggests

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Genetic testing may help clinicians select the most appropriate blood thinner medication for patients, according to a study published March 17 in ACC: Cardiovascular Intervention.

The testing can detect patients who have a genetic variant that interferes with the body's ability to metabolize and activate the antiplatelet drug clopidogrel. Heart patients are often prescribed this drug to lower the risk of blood clots, stroke and heart attack. 

Researchers at Rochester, Minn.-based Mayo Clinic, the University of Toronto and several other organizations analyzed data on nearly 16,000 patients taking blood thinners from more than 1,000 past studies to assess the genetic mutation's effect on ischemic events. 

For patients without the genetic variant, there was no difference in whether they received clopidogrel versus newer blood thinner medications like ticagrelor or prasugrel. However, patients who were identified as genetic variant carriers and given the newer medications had a 30 percent lower risk of ischemic events. 

"This information means that with the help of genetic testing, we could safely prescribe generic, well-tolerated, once-daily clopidogrel to most patients and reserve the use of the newer, more expensive drugs ― ticagrelor or prasugrel ― for those with the loss-of-function genetic variants," study author Naveen Pereira, MD, a cardiologist at Mayo Clinic, said in a news release.

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