Association of CYP2C19*2 polymorphism with clopidogrel response and 1-year major adverse cardiovascular events in a multiethnic population with drug-eluting stents

作者：Tan Shirley Siang Ning^*; Fong Alan Yean Yip; Mejin Melissa; Gerunsin Jerry; Kong Khai Liy; Chin Felicia Yien Yin; Tiong Lee Len; Lim Melissa Siaw Han; Said Asri; Khiew Ning Zan; Voon Chi Yen; Amin Nor Hanim Mohd; Cham Yee Ling; Koh Keng Tat; Oon Yen Yee; Ong Tiong Kiam

来源：Pharmacogenomics, 2017, 18(13): 1225-1239.

DOI：10.2217/pgs-2017-0078

• CYP2C19*2 genetic polymorphism
• double antiplatelet therapy
• percutaneous coronary intervention
• platelet function test

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.

• 出版日期2017-8