For some cardiac patients, recovery from a common heart procedure can be complicated by a single gene responsible for drug processing. The risk could be lowered with the first bedside genetic test of its kind. The test shows promise for quickly and easily identifying patients who need a different medication.
After a patient receives a heart stent—a small scaffold that props open an artery—his or her doctor will prescribe a blood thinner to prevent platelets from building up inside the device. However, for some 70 percent of patients with Asian ancestry and 30 percent of patients with African or European ancestry, a single genetic variant will prevent one of the most commonly prescribed blood thinners from working. Alternatives exist, but they are more expensive, so hospitals could use an easy way to identify who does and does not need the more expensive drug.
Canada’s Spartan Bioscience has developed a near “plug-and-play” genotyping device that allows nurses and others to quickly screen patients at the bedside, perhaps while they are undergoing the stent placement procedure. Users take a DNA sample from a patient’s cheek with a specialized swab, add the sample to a disposable tube, and then place the tube and sample in a proprietary shoebox-sized machine and hit a button. Shortly thereafter, the user receives a printout of the patient’s genetic status for the drug-processing variant. The whole procedure takes about an hour. Most clinicians currently have to wait several days for similar information to come from off-site genetics testing companies.
“For six years we’ve been plugging away at this, and we finally broke through about a year and a half ago,” says Spartan Bioscience founder Paul Lem. He says the simple test came to life with innovations at every step—from the special swab that collects the right amount of DNA, to the chemicals in the disposable reaction tube, to the software that automates the DNA reading—and a team with diverse backgrounds including his in medicine and molecular biology and others’ in optical hardware.
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