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Correlation between the CYP2C19 phenotype status and the results of three different platelet function tests in cardiovascular disease patients receiving antiplatelet therapy: an emphasis on newly introduced platelet function analyzer-200 P2Y test.

Li S, Choi JL, Guo LZ, Goh RY, Kim BR, Woo KS, Kim MH, Han JY - Ann Lab Med (2016)

Bottom Line: Light transmittance aggregometry (LTA) and the VerifyNow system showed that the post-procedure values for EM patients were lower than those of IM and PM patients (LTA: 24.4±15.7, 34.1±17.6, and 42.2±16.9, respectively, P<0.001; VerifyNow: 133.2±60.5, 171.5±42.6, and 218.7±59.3, respectively, P<0.001).Approximately, 59.0% of Korean patients with cardiovascular disease receiving clopidogrel had CYP2C19 loss-of-function genotypes classified as IM or PM, and the frequency was similar to the data from Asian people.The PFA-200, LTA, and VerifyNow platelet function tests revealed evidence of a significant association between the efficacy of clopidogrel and CYP2C19 genotypes.

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea.

ABSTRACT

Background: An association has been reported between CYP2C19 polymorphism and the altered antiplatelet activity of clopidogrel. We investigated this association using the newly introduced platelet function analyzer (PFA)-200 (INNOVANCE PFA-200 System; Siemens Healthcare, Germany) P2Y test.

Methods: Polymorphisms of CYP2C19*2, *3, *17 and the degree of inhibition of platelet function were determined in 83 patients. Three different platelet function tests were used to evaluate the degree of platelet inhibition and to check the association with genotype.

Results: The post-procedure PFA-200 values of extensive metabolizers (EM) patients (285.3±38.8) were higher than those of intermediate metabolizers (IM) and poor metabolizers (PM) patients (227.7±98.3 and 133.7±99.2, respectively; P=0.024). Light transmittance aggregometry (LTA) and the VerifyNow system showed that the post-procedure values for EM patients were lower than those of IM and PM patients (LTA: 24.4±15.7, 34.1±17.6, and 42.2±16.9, respectively, P<0.001; VerifyNow: 133.2±60.5, 171.5±42.6, and 218.7±59.3, respectively, P<0.001). The high residual platelet reactivity (HPR) rates were significantly different among the EM, IM, and PM groups using PFA-200 (PM:IM:EM=82.4:40.6:11.8, P<0.001).

Conclusions: Approximately, 59.0% of Korean patients with cardiovascular disease receiving clopidogrel had CYP2C19 loss-of-function genotypes classified as IM or PM, and the frequency was similar to the data from Asian people. The PFA-200, LTA, and VerifyNow platelet function tests revealed evidence of a significant association between the efficacy of clopidogrel and CYP2C19 genotypes.

No MeSH data available.


Related in: MedlinePlus

The percentage of high platelet reactivity (HPR) measured post-percutaneous coronary intervention (PCI) in different groups. (A) PFA-200; (B) Light transmittance aggregometry (LTA); (C) VerifyNow.
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Figure 3: The percentage of high platelet reactivity (HPR) measured post-percutaneous coronary intervention (PCI) in different groups. (A) PFA-200; (B) Light transmittance aggregometry (LTA); (C) VerifyNow.

Mentions: Using the criteria reported in the literature [111213], we also compared the post-procedure HPR rate among different CYP2C19 phenotypes and platelet function results (Fig. 3). PFA-200 assays showed that the HPR rate significantly differed among the EM, IM, and PM groups (PM:IM:EM=82.4:40.6: 11.8; P<0.001). Similar results were observed for LTA, and we observed a higher HPR rate in the IM and PM groups than that in the EM group (PM:IM:EM=35.3:18.8:5.9; P=0.048). We also observed a higher HPR rate in the PM group than the IM and EM groups for the VerifyNow results. However, although HPR rate was higher in the IM group, there was no statistically significant difference compared with the EM group (PM:IM: EM=58.8:21.9:11.8; P=0.001).


Correlation between the CYP2C19 phenotype status and the results of three different platelet function tests in cardiovascular disease patients receiving antiplatelet therapy: an emphasis on newly introduced platelet function analyzer-200 P2Y test.

Li S, Choi JL, Guo LZ, Goh RY, Kim BR, Woo KS, Kim MH, Han JY - Ann Lab Med (2016)

The percentage of high platelet reactivity (HPR) measured post-percutaneous coronary intervention (PCI) in different groups. (A) PFA-200; (B) Light transmittance aggregometry (LTA); (C) VerifyNow.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4697342&req=5

Figure 3: The percentage of high platelet reactivity (HPR) measured post-percutaneous coronary intervention (PCI) in different groups. (A) PFA-200; (B) Light transmittance aggregometry (LTA); (C) VerifyNow.
Mentions: Using the criteria reported in the literature [111213], we also compared the post-procedure HPR rate among different CYP2C19 phenotypes and platelet function results (Fig. 3). PFA-200 assays showed that the HPR rate significantly differed among the EM, IM, and PM groups (PM:IM:EM=82.4:40.6: 11.8; P<0.001). Similar results were observed for LTA, and we observed a higher HPR rate in the IM and PM groups than that in the EM group (PM:IM:EM=35.3:18.8:5.9; P=0.048). We also observed a higher HPR rate in the PM group than the IM and EM groups for the VerifyNow results. However, although HPR rate was higher in the IM group, there was no statistically significant difference compared with the EM group (PM:IM: EM=58.8:21.9:11.8; P=0.001).

Bottom Line: Light transmittance aggregometry (LTA) and the VerifyNow system showed that the post-procedure values for EM patients were lower than those of IM and PM patients (LTA: 24.4±15.7, 34.1±17.6, and 42.2±16.9, respectively, P<0.001; VerifyNow: 133.2±60.5, 171.5±42.6, and 218.7±59.3, respectively, P<0.001).Approximately, 59.0% of Korean patients with cardiovascular disease receiving clopidogrel had CYP2C19 loss-of-function genotypes classified as IM or PM, and the frequency was similar to the data from Asian people.The PFA-200, LTA, and VerifyNow platelet function tests revealed evidence of a significant association between the efficacy of clopidogrel and CYP2C19 genotypes.

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea.

ABSTRACT

Background: An association has been reported between CYP2C19 polymorphism and the altered antiplatelet activity of clopidogrel. We investigated this association using the newly introduced platelet function analyzer (PFA)-200 (INNOVANCE PFA-200 System; Siemens Healthcare, Germany) P2Y test.

Methods: Polymorphisms of CYP2C19*2, *3, *17 and the degree of inhibition of platelet function were determined in 83 patients. Three different platelet function tests were used to evaluate the degree of platelet inhibition and to check the association with genotype.

Results: The post-procedure PFA-200 values of extensive metabolizers (EM) patients (285.3±38.8) were higher than those of intermediate metabolizers (IM) and poor metabolizers (PM) patients (227.7±98.3 and 133.7±99.2, respectively; P=0.024). Light transmittance aggregometry (LTA) and the VerifyNow system showed that the post-procedure values for EM patients were lower than those of IM and PM patients (LTA: 24.4±15.7, 34.1±17.6, and 42.2±16.9, respectively, P<0.001; VerifyNow: 133.2±60.5, 171.5±42.6, and 218.7±59.3, respectively, P<0.001). The high residual platelet reactivity (HPR) rates were significantly different among the EM, IM, and PM groups using PFA-200 (PM:IM:EM=82.4:40.6:11.8, P<0.001).

Conclusions: Approximately, 59.0% of Korean patients with cardiovascular disease receiving clopidogrel had CYP2C19 loss-of-function genotypes classified as IM or PM, and the frequency was similar to the data from Asian people. The PFA-200, LTA, and VerifyNow platelet function tests revealed evidence of a significant association between the efficacy of clopidogrel and CYP2C19 genotypes.

No MeSH data available.


Related in: MedlinePlus