A new rapid genetic point-of-care test for patients after they have had a heart attack will be trialled at Manchester Royal Infirmary – part of Manchester University NHS Foundation Trust (MFT).

The Advanced Diagnostics Accelerator programme and the Genotype Guided Primary Coronary Intervention (Guide PCI) programme, undertaken in collaboration with the British Heart Foundation (BHF) Centre of Excellence, aims to assess the value and feasibility of using the Genedrive® CYP2C19 point of care test in cardiovascular disease to improve patient outcomes.

According to the British Heart Foundation, there are more than 7.6 million people living with a heart or circulatory disease in the UK, and there are over 100,000 hospital admissions each year due to heart attacks[i]. These patients require lifelong therapy, and there are several types of medicines available to support their treatment, with existing recommendations from health systems around the world look to balance the effectiveness of the treatment, the risk of bleeding, whilst reducing costs.

There is now strong evidence to suggest that pharmacogenetic testing can be used to select the most effective medicines for patients. Specifically, CYP2C19 genotyping can identify those patients who will respond to clopidogrel and highlight individuals who would benefit from an alternative treatment.

CYP2C19 genotyping is already recommended by the National Institute for Health & Care Excellence (NICE) prior to treatment in stroke and transient ischaemic attack (TIA). Due to the speed of obtaining a result, the Genedrive® CYP2C19-ID kit is recommended as the first line point of care test, and this technology is currently available for all patients admitted with stroke and TIA at Salford Royal Hospital, part of the Northern Care Alliance.

Data suggests that this approach would improve patient outcomes, reduce adverse events, and save money for health systems. As a result, the American Heart Association (AHA) recently released a scientific statement affirming that the evidence supports CYP2C19 genetic testing. However, the statement also highlighted that clinical implementation would depend on results being made available rapidly.

The Genotype Guided Primary Coronary Intervention (Guide PCI) programme at (MFT) and supported by Health Innovation Manchester as part of the Health Innovation Accelerator programme, aims to embed the Genedrive® CYP2C19-ID Kit into routine practice.

Over a 12-month period, clinicians will use the Genedrive® CYP2C19-ID Kit for patients undergoing PCI, rapidly identifying which treatment they should receive. This programme will establish the feasibility and value of this intervention, supporting roll out at other centres.

Dr Jaydeep Sarma, Consultant Interventional Cardiologist at Manchester University NHS Foundation Trust (MFT), said: “The Greater Manchester Regional Primary PCI service operates 24 hours a day, 7 days a week, 365 days a year. Thousands of patients are seen rapidly for life saving interventions from across the region each year and it’s essential that their treatments are optimised as quicky as possible. Integration of this rapid test into routine practice means we can get patients on the right treatment the first time, improving outcomes for our patients and the service as a whole.”

Professor Maciej Tomaszewski, Deputy Director at the British Heart Foundation Manchester Centre of Research Excellence, Clinical Chair of Cardiovascular Medicine at The University of Manchester, Integrative Cardiovascular Medicine Co-Theme Lead at the National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre (BRC) and an Honorary Consultant Physician at Manchester University NHS Foundation Trust said: “This is fantastic example of pharmacogenomics research in action, which has a potential to change clinical practice in cardiology clinics, wards and hospitals. The BHF Manchester CRE supports cardiovascular pharmacogenomics research and the follow up implementation programmes across the spectrum of cardiovascular diseases.”

Bill Newman, Professor of Translational Genomic Medicine at The University of Manchester, Consultant in Genomic Medicine at MFT, and Rare Conditions Co-Theme Lead at the NIHR Manchester Biomedical BRC, said: “We’re already seeing the impact of rapid genetic testing for patients who have had stroke or TIAs, with our colleagues in centres around the country telling us they need results quickly to inform their practice and avoid delays to discharge. The evidence bases for genotype guided antiplatelet therapy in cardiovascular disease is arguably even stronger than for patients who have stroke or TIA. The Guide PCI programme is a logical extension of our pharmacogenomics programme and reflects the regions commitment to personalised medicine.”

Laura Rooney, Director of Strategy at Health Innovation Manchester, said: “Our work across the Health Innovation Accelerator programme involves some incredibly novel innovations and solutions that can positively impact on patients’ lives, health economics across the system, and our regional offer as a world-leading innovation system. This genetic test aligns with all of the above, and has only been possible through collaboration with industry, academia and clinical partners, all working to a common goal. The news that the Accelerator programme has been extended, means that life-changing solutions like this work in the genomic treatment space can continue with momentum, and means that patients across our region who suffer from a heart attack, or a stroke can receive the best treatment they need to recover.”

The Genedrive® CYP2C19-ID Kit is also currently being deployed in Greater Manchester as part of the Development and Validation of Technology for Time Critical Genomic Testing (DEVOTE) Programme, being used to guide stroke therapy.

As well as expanding a skilled workforce in Greater Manchester, analysis suggests that the CYP2C19 stroke therapy has the potential to avoid thousands of strokes each year – impacting on population health outcomes and cost savings across the NHS.

The DEVOTE programme is led by The University of Manchester and supported by Health Innovation Manchester in partnership with Manchester University NHS Foundation Trust (MFT), Genedrive, Chromition, APIS Assay Technologies Ltd, and EMQN CIC, delivered as part of the Health Innovation Accelerator.

Read more about the DEVOTE programme here: https://healthinnovationmanchester.com/our-work/devote/

The Health Innovation Accelerator

The Health Innovation Accelerator encompasses two projects, the Advanced Diagnostics Accelerator and the DEVOTE programme, delivered through a partnership between Health Innovation Manchester, Manchester University NHS Foundation Trust (MFT), The University of Manchester, and industry partners.

This project is part-funded by the Greater Manchester Innovation Accelerator programme. Led by Innovate UK on behalf of UK Research and Innovation, the pilot Innovation Accelerators programme invested £100m in 26 transformative R&D projects between 2022-25 to accelerate the growth of three high-potential innovation ecosystems – Glasgow City Region, Greater Manchester and West Midlands. The programme was boosted by an additional £30m of public funding for 2025/26 spread equally across the regions.  Innovation Accelerators is piloting a new model of R&D decision making that empowers local partnerships to harness innovation to drive regional economic growth, attract private investment, and develop future technologies.

[i] Reference – read more via the British Heart Foundation here.