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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

Clinical outcomes in different CYP2C19 genotypes, with or without CR, at 12-month follow-up.Abbreviations: CR, clopidogrel resistance; ACE, adverse cardiovascular events.
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pone.0132561.g002: Clinical outcomes in different CYP2C19 genotypes, with or without CR, at 12-month follow-up.Abbreviations: CR, clopidogrel resistance; ACE, adverse cardiovascular events.

Mentions: The primary clinical endpoint, which was the cumulative incidence of recurrent angina, AMI, cerebral stroke, intra-stent thrombosis, and SCD, was observed in 25 patients (22.7%) during the follow-up. Recurrent angina, AMI, and intra-stent thrombosis occurred less often in CYP2C19 681 GG patients than CYP2C19 681A allele (GA+AA) patients (2/59 vs. 8/51, 1/59 vs. 6/51, 0 vs. 4/51, respectively, p < 0.05). However, the incidence of cerebral stroke and SCD was similar in both the groups (p > 0.05) (Table 3). The clinical outcomes in different CYP2C19 genotypes, with or without CR, at 12 months follow-up are shown in Fig 2.


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)

Clinical outcomes in different CYP2C19 genotypes, with or without CR, at 12-month follow-up.Abbreviations: CR, clopidogrel resistance; ACE, adverse cardiovascular events.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0132561.g002: Clinical outcomes in different CYP2C19 genotypes, with or without CR, at 12-month follow-up.Abbreviations: CR, clopidogrel resistance; ACE, adverse cardiovascular events.
Mentions: The primary clinical endpoint, which was the cumulative incidence of recurrent angina, AMI, cerebral stroke, intra-stent thrombosis, and SCD, was observed in 25 patients (22.7%) during the follow-up. Recurrent angina, AMI, and intra-stent thrombosis occurred less often in CYP2C19 681 GG patients than CYP2C19 681A allele (GA+AA) patients (2/59 vs. 8/51, 1/59 vs. 6/51, 0 vs. 4/51, respectively, p < 0.05). However, the incidence of cerebral stroke and SCD was similar in both the groups (p > 0.05) (Table 3). The clinical outcomes in different CYP2C19 genotypes, with or without CR, at 12 months follow-up are shown in Fig 2.

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