Point-of-Care Phenotypic and Genetic Testing for Patients with Acute Coronary Syndrome

 Clopidogrel is recommended as part of dual antiplatelet therapy (DAT) for clot prevention in patients with acute coronary syndrome (ACS). Clopidogrel is a prodrug that requires activation by CYP2C19 enzymes in the liver. It is expected that 16% to 50% of clopidogrel-treated patients who have ACS may not fully benefit from the protective effect of clopidogrel, potentially remaining at an increased risk of experiencing a major adverse cardiovascular event (MACE), because loss-offunction (LOF) mutations in the CYP2C19 gene prevent them from fully metabolizing clopidogrel. 1-3