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Genes Could Highlight Plavix Users at Clot Risk After Stent
Date:10/25/2011

By Amanda Gardner
HealthDay Reporter

TUESDAY, Oct. 25 (HealthDay News) -- Scientists have identified mutations in three genes that make certain patients more likely to have a potentially fatal blood clot after undergoing heart stent placement.

The genes are involved in metabolism of the drug Plavix (clopidogrel), a widely used blood thinner, and in platelet formation, according to a study published in the Oct. 26 issue of the Journal of the American Medical Association.

"This goes back to the idea of tailored medicine but [gene testing] is not feasible to do on everybody," said Dr. John Gassler, associate professor of medicine at the University of Rochester Medical Center, who was not involved with the research. "This study is very strongly thought-provoking but I don't think it can alter practice until it's been evaluated [further]."

The authors of the study also reported that a higher initial dose of Plavix reduced the risk of stent thrombosis (blood clot formation), while using proton pump inhibitors -- common drugs to treat gastroesophageal reflux disease (GERD) and stomach ulcers -- upped the risk.

People who get stents to prop open blocked arteries routinely receive two different blood thinners to reduce the risk of stent thrombosis. This has cut the rate of stent thrombosis tremendously, but up to 4 percent of patients still end up with this devastating complication, according to background information in the study.

The study authors analyzed 23 gene variants in 15 genes in 123 patients who had undergone percutaneous coronary intervention in France and who had experienced stent thrombosis.

These patients were compared to 246 similar patients who had not had stent thrombosis.

Three genotypes and two clinical factors -- Plavix loading (initial) dose and use of proton pump inhibitors -- all affected the risk of stent thrombosis.

When the investigators combined the
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