Pharmacogenomic Information for P2Y₁₂ Decisions: Still Lacking for Definitive Evidence

The value of using pharmacogenomics information to guide choices for P2Y₁₂ receptor antagonist antiplatelet agents has yet to be determined, but the value of generating more evidence is apparent. Investigators conducted a prospective, randomized, multicenter trial (NCT03347435) testing the effect of a bedside instrument obtaining genomic information on clopidogrel metabolism to select the P2Y₁₂ receptor antagonist in dual antiplatelet therapy among 888 patients with acute coronary syndromes (mean age, 70). The trial was discontinued early, with only 25% of the planned enrollment, because the instrument used for genomic analysis was not certified.

In the standard arm (drug selection based on clinical characteristics only), 51% of patients rec…