PCV36 COST-EFFECTIVENESS OF THE CYP2C19 GENOTYPE-GUIDED ANTIPLATELET THERAPY COMPARED TO UNIVERSAL USE OF TICAGRELOR OR CLOPIDOGREL IN QATAR

Abstract

The decision of antiplatelet therapy after a percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) patients is complicated. Clopidogrel requires activation by cytochrome P450 (CYP), primarily CYP2C19. Patients with CYP2C19 loss-of-function alleles are at increased risk of major adverse cardiovascular events. Ticagrelor is a more effective and expensive alternative antiplatelet agent that is unaffected by the CYP2C19 polymorphism. Genotype-guided therapy is used to determine the CYP2C19 mutation carrier’s status so that the more expensive ticagrelor can be selectively prescribed to patients with loss-of-function alleles.