China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Stroke Vasc Neurol. 2021 Jun;6(2):274-279. doi: 10.1136/svn-2021-000874. Epub 2021 May 5.
Rapid genotyping is useful for guiding early antiplatelet therapy in patients with high-risk nondisabling ischaemic cerebrovascular events (HR-NICE). Conventional genetic testing methods used in genotype-guided antiplatelet therapy for patients with HR-NICE did not satisfy the needs of the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE)-2 trial. Therefore, we developed the rapid-genotyping GMEX (point-of-care) system to meet the needs of the CHANCE-2 trial.
Healthy individuals and patients with history of cardiovascular diseases (n=408) were enrolled from six centres of the CHANCE-2 trial. We compared the laboratory-based genomic test results with Sanger sequencing test results for accuracy verification. Next, we demonstrated the accuracy, timeliness and clinical operability of the GMEX system compared with laboratory-based technology (YZY Kit) to verify whether the GMEX system satisfies the needs of the CHANCE-2 trial.
Genotypes reported by the GMEX system showed 100% agreement with those determined by using the YZY Kit and Sanger sequencing for all three alleles (*2, *3 and *17) tested. The average result's turnaround times for the GMEX and YZY Kit methods were 85.0 (IQR: 85.0-86.0) and 1630.0 (IQR: 354.0-7594.0) min (p<0.001), respectively.
Our data suggest that the GMEX system is a reliable and feasible point-of-care system for rapid genotyping for the CHANCE-2 trial or related clinical and research applications.
快速基因分型对于指导高危非致残性缺血性脑血管事件(HR-NICE)患者的早期抗血小板治疗非常有用。用于指导 HR-NICE 患者抗血小板治疗的传统基因检测方法不能满足氯吡格雷在急性非致残性脑血管事件高危患者(CHANCE-2 试验)中的需求。因此,我们开发了快速基因分型 GMEX(即时)系统以满足 CHANCE-2 试验的需求。
从 CHANCE-2 试验的六个中心招募了 408 名健康个体和有心血管疾病史的患者。我们将基于实验室的基因组测试结果与 Sanger 测序测试结果进行比较,以验证准确性。接下来,我们展示了 GMEX 系统与基于实验室的技术(YZY 试剂盒)相比在准确性、及时性和临床可操作性方面的优势,以验证 GMEX 系统是否满足 CHANCE-2 试验的需求。
GMEX 系统报告的基因型与使用 YZY 试剂盒和 Sanger 测序确定的所有三种等位基因(*2、*3 和 *17)的基因型完全一致。GMEX 和 YZY 试剂盒方法的平均结果周转时间分别为 85.0(IQR:85.0-86.0)和 1630.0(IQR:354.0-7594.0)min(p<0.001)。
我们的数据表明,GMEX 系统是一种可靠且可行的即时护理系统,可用于 CHANCE-2 试验或相关临床和研究应用中的快速基因分型。