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Doubt Cast on Use of Genetic Test Before Plavix
Date:12/28/2011

WEDNESDAY, Dec. 28 (HealthDay News) -- A new review of existing research suggests that, despite a federal recommendation, genetic testing won't help physicians determine which heart patients should get Plavix, a blood-thinning drug used to treat certain cardiac conditions.

Plavix, also known as clopidogrel, is used to treat or prevent blood clots due to the clogging of arteries and after such surgical procedures as balloon angioplasty.

But some patients won't experience the drug's clot-preventing benefits if their bodies don't process it properly, potentially leading to heart attack, blood clots in stents and death, according to Dr. Jean-Sebastien Hulot, associate professor of medicine at the Cardiovascular Research Center at Mount Sinai School of Medicine. Or, he said, they could experience the reverse -- excessive bleeding if the medication has too much of an effect. Hulot was not involved with the study, but is familiar with the findings.

The U.S. Food and Drug Administration believes that genetic testing could help identify patients who won't respond well to the drug. But the American Heart Association and the American College of Cardiologists have been skeptical that the genetic testing in question is useful.

In the new review, Dr. Michael V. Holmes of University College London and colleagues examined 32 studies that included over 42,000 patients. They looked for signs of bleeding problems, blood clots in stents and cardiovascular problems.

They also conducted a meta-analysis in which they examined statistics in the studies as a whole.

While they mention some statistical caveats, the researchers found that a specific genetic trait -- linked to the body's ability to respond to the drug -- did not significantly affect the risk of cardiovascular problems.

In a commentary accompanying the study, Dr. Steven E. Nissen, borrowing a phrase from a former chairman of the Federal Reserve, wrote
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Doubt Cast on Use of Genetic Test Before Plavix
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