Exceltox Laboratories offers genetic and pharmacogenetic testing to help guide therapy decisions for cardiovascular diseases. Their testing panel examines factors that influence thrombosis risk, and metabolism of common cardiac drugs like platelet inhibitors, beta blockers, and warfarin. This includes testing for Factor II, Factor V Leiden mutations, and CYP450 enzyme variants involved in drug metabolism. Understanding a patient's genetic profile can help identify medication risks and optimize treatment by selecting the right drug and dosage.

1. L A B O R A T O R I E S
Exceltox offers an extensive menu of testing
for cardiac disorders that can help
determine the risk of thrombosis or
prothrombin deficiency to ultimately guide
therapy decisions for commonly prescribed
drugs for cardiovascular disease.
The Exceltox panel for genetic and
pharmacogenetic testing of cardiac
disorders includes:
• Factor II (Prothrombin)
• Factor V Leiden (Inherited Thrombophilia)
• CYP450 2C19 platelet inhibitor metabolism
• CYP450 2D6 beta blocker metabolism
• Warfarin sensitivity
L A B O R A T O R I E S
MOLECULAR PROFILING FOR
CARDIAC DISORDERS
Know a patient's molecular genotype for cardiac disorders
and response to cardiac therapies.

2. Comprehensive Testing for Cardiac Disorders
Factor II and Factor V Leiden
Factor II and Factor V are important components of
the coagulation cascade. Testing for Factor ll and
Factor V Leiden mutations provides important
information in a differential diagnosis for the clinical
presentation of thrombophilia. Factor V is the most
common variant associated with inherited
thrombosis, with a population frequency ranging
from 3-8% in the United States. Factor II is the
second most common mutation -- present in 1-2% of
the general population.
Based on the dominant mode of inheritance, the
testing of direct family members (parents, siblings
and children) is strongly recommended.
Warfarin Sensitivity
Warfarin interferes with the recycling of Vitamin K, which can result in reduced activation of several clotting
factors and diminished clotting ability. Consequently, bleeding complications are a highly prevalent cause of
morbidity and mortality in patients who receive warfarin.5
A recent study revealed that warfarin genotyping reduced the risk of hospitalization due to thromboembolism
or bleeding in outpatients. It concluded that genotyping should be strongly considered in patients beginning
warfarin treatment.6
According to the FDA, all patients who are candidates for Coumadin (warfarin) therapy should be tested for
their genotype prior to initiating treatment.7
CYP450 2C19 and 2D6
Plavix®
(clopidogrel) is the world’s second most
prescribed drug. Variation in Cytochrome P450
2C19-mediated metabolism is a key source of
variability underlying patient reaction to Plavix
(clopidogrel).1
CYP450 D6 testing may also be considered medically
necessary for patients with cardiovascular disease
who are undergoing treatment with certain drugs.
According to recent studies, genetic testing for
variations in CYP2D6 and CYP2C19 may result in
improved patient management, a decrease in
episodes of drug toxicity, drug selection and/or
dosage adjustment informed by genetic testing for
variations in CYP250 2C19 and 2D6 may also enable
improved pain and fewer adverse drug interactions.2-4
References
1. Mega, et al. JAMA. 2010;304:1821-30. 2. Jannetto PJ, Bratanow NC. Pain management in the 21st century. Expert Opin Drug Metab Toxicol.
2011;7:745-752. 3. De Gregori M, Allegri M, De Gregori S, et al. How and why to screen for CYP2D6 interindividual variability in patients under
pharmacological treatments. Curr Drug Metab. 2010;11:276-282. 4. Rollason V, Samer C, Piguet V, et al. Pharmacogenetics of analgesics.
Pharmacogenomics. 2008;9:905-933. 5. Wysowski D, et al. Bleeding Complications With Warfarin Use. Arch Intern Med
2007;167(13):1414-1419. 6. Epstein et al. Warfarin Genotyping Reduces Hospitalization Rates. J Am Coll. Cardiol; 2010;55:2804-12. 7. FDA,
Black Box Warning, Coumadin, October 2006.
Benefits of Genetic and Pharmacogenetic Testing for Cardiac Disorders:
Knowing a patient's molecular profile for cardiac
disorders and their response to cardiac therapies.
That’s personalized medicine,
powered by Exceltox for cardiac disorders.
• Genetic testing with Factor II and Factor V Leiden
may provide important information in a
differential diagnosis for the clinical presentation
for thrombophilia.
• Pharmacogenetic testing information adheres to
FDA guidelines that require genotyping prior to
initiating treatment.
• Pharmacogenetic testing for cardiac disorders
may help physicians implement the appropriate
drug and dosage to minimize the risk of minor to
life threatening reactions and ensure optimal
response.
DCO 011-001 8/27/14
L A B O R A T O R I E S
Excellence in Science, Service, & Results.
info@exceltox.com
Client Services (877) 202-7019