This page is part of the Genetic Reporting Implementation Guide (v2.0.0: STU 2) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
<Observation xmlns="http://hl7.org/fhir">
<id value="TxImp01"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/therapeutic-implication"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Poor metabolizer of Clopidogrel</div>
</text>
<extension
url="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomics-artifact">
<valueRelatedArtifact>
<type value="citation"/>
<url
value="https://cpicpgx.org/guidelines/guideline-for-clopidogrel-and-cyp2c19)"/>
</valueRelatedArtifact>
</extension>
<status value="final"/>
<category>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system
value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
<code value="therapeutic-implication"/>
</coding>
</code>
<derivedFrom>
<reference value="Observation/Pgx-geno-1001"/>
</derivedFrom>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="51963-7"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://ncimeta.nci.nih.gov"/>
<code value="C0070166"/>
<display value="clopidogrel"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
<code value="predicted-therapeutic-implication"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA9657-3"/>
<display value="Poor metabolizer"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
<code value="conclusion-string"/>
</coding>
</code>
<valueString
value="For clopidogrel, individuals with this diplotype are expected to have significantly reduced platelet inhibition, increased residual platelet aggregation and increased risk for adverse cardiovascular events in response to clopidogrel. Alternative antiplatelet therapy (if no contraindication) is recommended. Refer to current guidelines for dosage and recommendations at https://cpicpgx.org/guidelines/guideline- for-clopidogrel-and-cyp2c19/"/>
</component>
</Observation>