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none 107 si Non presente mixed Valgimigli, Marco*; Bueno, Héctor; Byrne, Robert A.; Collet, Jean-Philippe; Costa, Francesco; Jeppsson, Anders; Kastrati, Adnan; Kolh, Philippe; Mauri, Laura; Montalescot, Gilles; Neumann, Franz-Josef; Petricevic, Mate; Roffi, Marco; Steg, Philippe Gabriel; Zamorano, Jose Luis; Levine, Glenn N.; Badimon, Lina; Vranckx, Pascal; Agewall, Stefan; Andreotti, Felicita; Antman, Elliott; Barbato, Emanuele; Bassand, Jean-Pierre; Bugiardini, Raffaele; Cikirikcioglu, Mustafa; Cuisset, Thomas; De Bonis, Michele; Delgado, Victora; Fitzsimons, Donna; Galiè, Nazzareno; Gilard, Martine; Hamm, Christian W.; Ibanez, Borja; James, Stefan; Knuuti, Juhani; Landmesser, Ulf; Leclercq, Christophe; Lettino, Maddalena; Lip, Gregory; Piepoli, Massimo Francesco; Pierard, Luc; Schwerzmann, Markus; Sechtem, Udo; Simpson, Iain A.; Uva, Miguel Sousa; Stabile, Eugenio; Storey, Robert F.; Tendera, Michal; Van De Werf, Frans; Verheugt, Freek; Aboyans, Victor; Windecker, Stephan; Coca, Antonio; Coman, Ioan Mircea; Dean, Veronica; Delgado, Victoria; Gaemperli, Oliver; Hindricks, Gerhard; Iung, Bernard; Jüni, Peter; Katus, Hugo A.; Lancellotti, Patrizio; McDonagh, Theresa; Ponikowski, Piotr; Richter, DImitrios J.; Shlyakhto, Evgeny; Roithinger, Franz Xaver; Aliyev, Farid; Stelmashok, Valeriy; Desmet, Walter; Postadzhiyan, Arman; Georghiou, Georgios P.; Motovska, Zuzana; Grove, Erik Lerkevang; Marandi, Toomas; Kiviniemi, Tuomas; Kedev, Sasko; Massberg, Steffen; Alexopoulos, DImitrios; Kiss, Robert Gabor; Gudmundsdottir, Ingibjorg Jona; McFadden, Eugène P.; Lev, Eli; De Luca, Leonardo; Sugraliyev, Akhmetzhan; Haliti, Edmond; Mirrakhimov, Erkin; Latkovskis, Gustavs; Petrauskiene, Birute; Huijnen, Steve; Magri, Caroline Jane; Cherradi, Rhizlan; Ten Berg, Jurrien M.; Eritsland, Jan; Budaj, Andrzej; Aguiar, Carlos Tavares; Duplyakov, Dmitry; Zavatta, Marco; Antonijevic, Nebojsa M.; Fras, Zlatko; Montoliu, Antonio Tello; Varenhorst, Christoph; Tsakiris, DImitri; Addad, Faouzi; Aydogdu, Sinan; Parkhomenko, Alexander; Kinnaird, Tim Valgimigli, Marco*; Bueno, Héctor; Byrne, Robert A.; Collet, Jean-Philippe; Costa, Francesco; Jeppsson, Anders; Kastrati, Adnan; Kolh, Philippe; Mauri, Laura; Montalescot, Gilles; Neumann, Franz-Josef; Petricevic, Mate; Roffi, Marco; Steg, Philippe Gabriel; Zamorano, Jose Luis; Levine, Glenn N.; Badimon, Lina; Vranckx, Pascal; Agewall, Stefan; Andreotti, Felicita; Antman, Elliott; Barbato, Emanuele; Bassand, Jean-Pierre; Bugiardini, Raffaele; Cikirikcioglu, Mustafa; Cuisset, Thomas; De Bonis, Michele; Delgado, Victora; Fitzsimons, Donna; Galiè, Nazzareno; Gilard, Martine; Hamm, Christian W.; Ibanez, Borja; James, Stefan; Knuuti, Juhani; Landmesser, Ulf; Leclercq, Christophe; Lettino, Maddalena; Lip, Gregory; Piepoli, Massimo Francesco; Pierard, Luc; Schwerzmann, Markus; Sechtem, Udo; Simpson, Iain A.; Uva, Miguel Sousa; Stabile, Eugenio; Storey, Robert F.; Tendera, Michal; Van De Werf, Frans; Verheugt, Freek; Aboyans, Victor; Windecker, Stephan; Coca, Antonio; Coman, Ioan Mircea; Dean, Veronica; Delgado, Victoria; Gaemperli, Oliver; Hindricks, Gerhard; Iung, Bernard; Jüni, Peter; Katus, Hugo A.; Lancellotti, Patrizio; McDonagh, Theresa; Ponikowski, Piotr; Richter, DImitrios J.; Shlyakhto, Evgeny; Roithinger, Franz Xaver; Aliyev, Farid; Stelmashok, Valeriy; Desmet, Walter; Postadzhiyan, Arman; Georghiou, Georgios P.; Motovska, Zuzana; Grove, Erik Lerkevang; Marandi, Toomas; Kiviniemi, Tuomas; Kedev, Sasko; Massberg, Steffen; Alexopoulos, DImitrios; Kiss, Robert Gabor; Gudmundsdottir, Ingibjorg Jona; McFadden, Eugène P.; Lev, Eli; De Luca, Leonardo; Sugraliyev, Akhmetzhan; Haliti, Edmond; Mirrakhimov, Erkin; Latkovskis, Gustavs; Petrauskiene, Birute; Huijnen, Steve; Magri, Caroline Jane; Cherradi, Rhizlan; Ten Berg, Jurrien M.; Eritsland, Jan; Budaj, Andrzej; Aguiar, Carlos Tavares; Duplyakov, Dmitry; Zavatta, Marco; Antonijevic, Nebojsa M.; Fras, Zlatko; Montoliu, Antonio Tello; Varenhorst, Christoph; Tsakiris, DImitri; Addad, Faouzi; Aydogdu, Sinan; Parkhomenko, Alexander; Kinnaird, Tim

Introduction: Clopidogrel, which is activated by the CYP2C19 enzyme, is among the drugs for which all major regulatory agencies recommend genetic testing to be performed to identify a patient’s CYP2C19 genotype in order to determine the optimal antiplatelet therapeutic scheme. The CYP2C19*2 and CYP2C19*3 variants are loss-of-function alleles, leading to abolished CYP2C19 function and thus have the risk of thrombotic events for carriers of these alleles on standard dosages, while the CYP2C19*17 allele results in CYP2C19 hyperactivity. Aims: Here, we report our findings from a retrospective study to assess whether genotyping for the CYP2C19*2 allele was cost effective for myocardial infarction patients receiving clopidogrel treatment in the Serbian population compared with the nongenotype-guided treatment. Results: We found that 59.3% of the CYP2C19*1/*1 patients had a minor or major bleeding event versus 42.85% of the CYP2C19*1/*2 and *2/*2, while a reinfarction event occurred only in 2.3% of the CYP21C9*1/*1 patients, compared with 11.2% of the CYP2C19*1/*2 and CYP2C19*2/*2 patients. There were subtle differences between the two patient groups, as far as the duration of hospitalization and rehabilitation is concerned, in favor of the CYP2C19*1/*1 group. The mean cost for the CYP2C19*1/*1 patients was estimated at (sic)2547 versus (sic)2799 in the CYP2C19*1/*2 and CYP2C19*2/*2 patients. Furthermore, based on the overall CYP2C19*1/*2 genotype frequencies in the Serbian population, a break-even point analysis indicated that performing the genetic test prior to drug prescription represents a cost-saving option, saving (sic)13 per person on average. Conclusion: Overall, our data demonstrate that pharmacogenomics-guided clopidogrel treatment may represent a cost-saving approach for the management of myocardial infarction patients undergoing primary percutaneous coronary intervention in Serbia.