Abstract
Background: Clopidogrel activity is influenced by cytochrome P450 (CYP450). CYP2C19 polymorphisms vary by ethnicity and region.
Objective: The aim of the study is to assess the effect of genetic polymorphisms in CYP2C19*2 and *3 and clinical and demographic factors on major adverse cardiovascular events (MACE) in Kazak patients following percutaneous coronary intervention (PCI).
Methods: 397 patients with PCI treated with clopidogrel and aspirin for at least 12 months were enrolled and outcomes within 1 year were recorded. Approximately 2 ml of peripheral venous blood samples were used for genotype detection. Multivariable logistic regression analyses were performed to identify factors associated with MACE.
Results: 95 patients (23.9%) suffered MACE during the period. Logistic regression analysis revealed CYP2C19*2 carriers (odds ratio [OR]: 2.431, 95% [confidence interval] CI: 1.136- 5.275, P = 0.027) and poor metabolizers (OR: 2.128, 95% CI: 0.899-4.82, P = 0.043) to be significantly associated with MACE.
Conclusion: The CYP2C19*2 allele variants and poor metabolizers were found to be associated with MACE in a clopidogrel-treated Kazak population with acute coronary syndrome following PCI.
Keywords: CYP2C19, Clopidogrel, percutaneous coronary intervention, Kazak, PCI, Major Adverse Cardiovascular Events (MACE).
Graphical Abstract
[PMID: 27026020]
[http://dx.doi.org/10.1161/CIRCINTERVENTIONS.119.007811] [PMID: 30998396]
[http://dx.doi.org/10.1016/j.thromres.2016.10.008] [PMID: 27728892]
[http://dx.doi.org/10.1038/tpj.2010.21] [PMID: 20351750]
[http://dx.doi.org/10.2147/PGPM.S5056] [PMID: 23226041]
[http://dx.doi.org/10.1056/NEJMoa0808227] [PMID: 19106083]
[http://dx.doi.org/10.1097/MD.0000000000020582] [PMID: 32702814]
[http://dx.doi.org/10.1007/s00228-021-03176-z] [PMID: 34164723]
[http://dx.doi.org/10.1111/bcp.12794] [PMID: 26426352]
[http://dx.doi.org/10.1093/eurheartj/ehp041] [PMID: 19193675]
[http://dx.doi.org/10.1007/s40265-013-0126-z] [PMID: 24114622]
[http://dx.doi.org/10.1111/jcpt.12254] [PMID: 25810245]
[http://dx.doi.org/10.1016/j.thromres.2011.04.010] [PMID: 21592545]
[http://dx.doi.org/10.1186/s12872-021-02201-4] [PMID: 34384383]
[http://dx.doi.org/10.3892/mmr.2018.8377] [PMID: 29328413]
[http://dx.doi.org/10.1038/clpt.2013.105] [PMID: 23698643]
[http://dx.doi.org/10.3109/09537104.2014.889291] [PMID: 24617511]
[http://dx.doi.org/10.1111/jth.12342] [PMID: 23809542]
[http://dx.doi.org/10.1016/j.ijcard.2012.09.075] [PMID: 23260377]
[http://dx.doi.org/10.1038/clpt.2011.34] [PMID: 21412232]
[http://dx.doi.org/10.1002/jcph.225] [PMID: 24214141]
[http://dx.doi.org/10.1016/j.clinthera.2018.06.001] [PMID: 30017169]
[http://dx.doi.org/10.1111/bcpt.13110] [PMID: 30098132]
[http://dx.doi.org/10.1186/s12944-021-01544-3] [PMID: 34563206]
[http://dx.doi.org/10.1016/S0140-6736(19)32519-X] [PMID: 31810609]
[http://dx.doi.org/10.2337/diacare.28.10.2554] [PMID: 16186300]
[http://dx.doi.org/10.1007/s12012-008-9024-0] [PMID: 18777166]
[http://dx.doi.org/10.1016/S0140-6736(05)66375-1] [PMID: 15836888]
[http://dx.doi.org/10.1253/circj.CJ-13-1292] [PMID: 24240435]
[http://dx.doi.org/10.1016/S0140-6736(05)67663-5] [PMID: 16271645]
[http://dx.doi.org/10.1080/09537104.2017.1394452] [PMID: 29206072]
[http://dx.doi.org/10.5694/mja13.10968] [PMID: 23984779]
[http://dx.doi.org/10.1111/iji.12511] [PMID: 32862511]