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Pharmacogenomics ; 18(13): 1225-1239, 2017 08.
Article in English | MEDLINE | ID: mdl-28745576

ABSTRACT

BACKGROUND: Patients undergoing elective percutaneous coronary intervention (PCI) with drug-eluting stents (DES) who have impaired clopidogrel response, have a higher risk of subsequent major adverse cardiovascular events (MACE). AIM OF THE STUDY: To establish the relationship between CYP2C19 genotype, clopidogrel responsiveness and 1-year MACE. MATERIALS & METHODS: Aspirin/clopidogrel responses were assessed with Multiplate Analyzer and CYP2C19*2 allele by SpartanRx. RESULTS: A total of 42.0% carried ≥1 CYP2C19*2 allele. Prevalences of aspirin and clopidogrel high on-treatment platelet reactivity (HPR; local cutoffs: 300 AU*min for aspirin and 600 AU*min for clopidogrel) were 11.5% and 19.8% respectively. In multivariate ana-lysis, clopidogrel HPR was found to be an independent predictor for 1-year MACE (adj HR: 3.48, p = 0.022 ). CONCLUSION: Having clopidogrel HPR could be a potentially modifiable risk factor guided by phenotyping.


Subject(s)
Cardiovascular Diseases/chemically induced , Cardiovascular Diseases/genetics , Cytochrome P-450 CYP2C19/genetics , Drug-Related Side Effects and Adverse Reactions/genetics , Platelet Aggregation Inhibitors/adverse effects , Polymorphism, Genetic/genetics , Ticlopidine/analogs & derivatives , Alleles , Clopidogrel , Cohort Studies , Drug-Eluting Stents/adverse effects , Female , Genotype , Humans , Male , Middle Aged , Platelet Aggregation Inhibitors/therapeutic use , Risk Factors , Ticlopidine/adverse effects , Ticlopidine/therapeutic use
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