Work

The effect of the CYP2C19*2 allele on cardiovascular outcomes in patients with coronary artery stenting: a prospective study

Year: 2018

Type: article

Abstract: Introduction: The aim of the study was to evaluate the effects of cytochrome P450 2C19*2 (CYP2C19*2) on ischemic and bleeding events in the Chinese Han population.Material and methods: Patients after coronary artery stenting were enrolled for genotyping CYP2C19*2.Platelet reactivity 4 weeks after stent implantation was compared between different genotype groups.Ischemic and bleeding events were compared after 6 months' follow-up.Results: A total of 255 patients were enrolled and 57.7% and 42.3% of patients presented with stable angina and acute coronary syndrome, respectively.The prevalence of homozygous (AA) and heterozygous (GA) CYP2C19*2 variants was 3.5% and 24.7% respectively, and the prevalence of wild type (GG) was 71.8%.Compared to GG and GA genotype groups, the absolute platelet activity reduction was significantly lower in AA genotype (GG 43.6 ±7.8%, GA 31.9 ±6.5%, and AA 24.8 ±5.3%, p < 0.01 for trend).After 6 months' follow-up, 3.3%, 4.8% and 11.1% of patients experienced ischemic events in GG, GA and AA genotype groups, respectively (p = 0.003 for trend).After adjusting for traditional risk factors, AA genotype was significantly associated with ischemic events, with hazard ratio 1.19 and 95% confidence interval 1.08-1.30(p = 0.013).Also, 2.2%, 1.6% and 0% of patients experienced bleeding events in GG, GA and AA genotype groups (p = 0.153 for trend).No independent association of CYP2C19*2 genotype and bleeding events was observed.Conclusions: Genotyping of CYP2C19*2 may be useful to guide antiplatelet treatment in the Chinese Han population.Randomized controlled trials are warranted to investigate whether genotype-guided antiplatelet treatment could reduce ischemic events.

Source: Archives of Medical Science

DOI: 10.5114/aoms.2018.75349

Authors: Dahao Yang, Changnong Peng, Zhiyong Liao, Xiaoqing Wang, Wenyu Guo, Jun Li

Institution: Jinan University

Language: English

Topic: Antiplatelet Therapy and Cardiovascular Diseases

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,078