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Cytochrome P450 CYP 2C19*2 Associated with Adverse 1-Year Cardiovascular Events in Patients with Acute Coronary Syndrome.

Wei YQ, Wang DG, Yang H, Cao H - PLoS ONE (2015)

Bottom Line: One hundred ten ACS patients undergoing percutaneous coronary intervention, who were followed-up for 1 year, were included in the study.Over a follow-up of 12 months, the incidence of recurrent angina, acute myocardial infarction, and intra-stent thrombosis in CYP2C19 681 GG carriers was significantly lower than that in CYP2C19 681A allele (GA + AA) group (2/59 vs. 8/51, 1/59 vs. 6/51, 0 vs. 4/51, respectively, p < 0.05).CYP 2C19*2 is associated with reduced clopidogrel antiplatelet activity and might be an important marker for poor prognosis of ACS.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, The First Affiliated Hospital of Wannan Medical College, Wuhu, China.

ABSTRACT

Background: The cytochrome P450 (CYP450) 2C19 681 genotypes affect the antiplatelet activity of clopidogrel. We investigated the correlation of CYP 2C19 681G > A mutation with clopidogrel resistance (CR). Additionally, we studied the effect of CR on clinical prognosis of patients with acute coronary syndrome (ACS).

Methods: One hundred ten ACS patients undergoing percutaneous coronary intervention, who were followed-up for 1 year, were included in the study. The patients were co-administered aspirin 100 mg/d and clopidogrel 75mg/d following a loading dose of 300 mg. CR was assessed on the basis of polymorphism observed in the CYP2C19 subgroup.

Results: Patients in GG genotype group exhibited greater inhibition of platelet aggregation than patients in GA and AA genotype groups (16.2 ± 10.1%; 10.2 ± 9.9%; 8.0 ± 5.9%, respectively, p < 0.01). CYP2C19 681GG genotype group was associated with lower CR than CYP2C19 681A allele (GA + AA) group (9/59 vs. (12+5)/51; p = 0.009). Over a follow-up of 12 months, the incidence of recurrent angina, acute myocardial infarction, and intra-stent thrombosis in CYP2C19 681 GG carriers was significantly lower than that in CYP2C19 681A allele (GA + AA) group (2/59 vs. 8/51, 1/59 vs. 6/51, 0 vs. 4/51, respectively, p < 0.05).

Conclusion: CYP 2C19*2 is associated with reduced clopidogrel antiplatelet activity and might be an important marker for poor prognosis of ACS.

No MeSH data available.


Related in: MedlinePlus

Flowchart of study participants.Flowchart of study participants from enrollment to follow-up. Abbreviations: ACS, acute coronary syndrome; PCI, percutaneous coronary intervention; FU, follow-up; CR, clopidogrel resistance; IPA, inhibition of platelet aggregation.
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pone.0132561.g001: Flowchart of study participants.Flowchart of study participants from enrollment to follow-up. Abbreviations: ACS, acute coronary syndrome; PCI, percutaneous coronary intervention; FU, follow-up; CR, clopidogrel resistance; IPA, inhibition of platelet aggregation.

Mentions: One hundred eighteen patients (8 patients lost to follow-up) were enrolled for the study (Fig 1). Baseline characteristics of the patients are demonstrated in Table 1. The number of patients with laboratory CR (ΔA < 10%) and non-CR (ΔA ≥ 10%) was 26 (23.6%) and 84 (76.4%), respectively. The demographic, clinical, and laboratory findings for the patients in the groups were similar (Table 1).


Cytochrome P450 CYP 2C19*2 Associated with Adverse 1-Year Cardiovascular Events in Patients with Acute Coronary Syndrome.

Wei YQ, Wang DG, Yang H, Cao H - PLoS ONE (2015)

Flowchart of study participants.Flowchart of study participants from enrollment to follow-up. Abbreviations: ACS, acute coronary syndrome; PCI, percutaneous coronary intervention; FU, follow-up; CR, clopidogrel resistance; IPA, inhibition of platelet aggregation.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493116&req=5

pone.0132561.g001: Flowchart of study participants.Flowchart of study participants from enrollment to follow-up. Abbreviations: ACS, acute coronary syndrome; PCI, percutaneous coronary intervention; FU, follow-up; CR, clopidogrel resistance; IPA, inhibition of platelet aggregation.
Mentions: One hundred eighteen patients (8 patients lost to follow-up) were enrolled for the study (Fig 1). Baseline characteristics of the patients are demonstrated in Table 1. The number of patients with laboratory CR (ΔA < 10%) and non-CR (ΔA ≥ 10%) was 26 (23.6%) and 84 (76.4%), respectively. The demographic, clinical, and laboratory findings for the patients in the groups were similar (Table 1).

Bottom Line: One hundred ten ACS patients undergoing percutaneous coronary intervention, who were followed-up for 1 year, were included in the study.Over a follow-up of 12 months, the incidence of recurrent angina, acute myocardial infarction, and intra-stent thrombosis in CYP2C19 681 GG carriers was significantly lower than that in CYP2C19 681A allele (GA + AA) group (2/59 vs. 8/51, 1/59 vs. 6/51, 0 vs. 4/51, respectively, p < 0.05).CYP 2C19*2 is associated with reduced clopidogrel antiplatelet activity and might be an important marker for poor prognosis of ACS.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, The First Affiliated Hospital of Wannan Medical College, Wuhu, China.

ABSTRACT

Background: The cytochrome P450 (CYP450) 2C19 681 genotypes affect the antiplatelet activity of clopidogrel. We investigated the correlation of CYP 2C19 681G > A mutation with clopidogrel resistance (CR). Additionally, we studied the effect of CR on clinical prognosis of patients with acute coronary syndrome (ACS).

Methods: One hundred ten ACS patients undergoing percutaneous coronary intervention, who were followed-up for 1 year, were included in the study. The patients were co-administered aspirin 100 mg/d and clopidogrel 75mg/d following a loading dose of 300 mg. CR was assessed on the basis of polymorphism observed in the CYP2C19 subgroup.

Results: Patients in GG genotype group exhibited greater inhibition of platelet aggregation than patients in GA and AA genotype groups (16.2 ± 10.1%; 10.2 ± 9.9%; 8.0 ± 5.9%, respectively, p < 0.01). CYP2C19 681GG genotype group was associated with lower CR than CYP2C19 681A allele (GA + AA) group (9/59 vs. (12+5)/51; p = 0.009). Over a follow-up of 12 months, the incidence of recurrent angina, acute myocardial infarction, and intra-stent thrombosis in CYP2C19 681 GG carriers was significantly lower than that in CYP2C19 681A allele (GA + AA) group (2/59 vs. 8/51, 1/59 vs. 6/51, 0 vs. 4/51, respectively, p < 0.05).

Conclusion: CYP 2C19*2 is associated with reduced clopidogrel antiplatelet activity and might be an important marker for poor prognosis of ACS.

No MeSH data available.


Related in: MedlinePlus