Effects of genetic variants on platelet reactivity and one-year clinical outcomes after percutaneous coronary intervention: A prospective multicentre registry study
Why the study?
Do CYP2C19 loss-of-function alleles increase the risk of adverse clinical outcomes in patients receiving clopidogrel after PCI with newer-generation drug-eluting stents?
Population
4,587 patients undergoing percutaneous coronary intervention with newer-generation drug-eluting stents…
Comparison
Presence of CYP2C19 loss-of-function alleles vs Patients with wild-type CYP2C19*1/*1 alleles
Design
Cohort
Follow-up
1 year
Authors
Discussion
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Member takes
Implication
CYP2C19 loss-of-function alleles were associated with higher cardiac death on clopidogrel post-PCI; leaves open whether genotyping improves outcomes with contemporary stents.
Structured PICO
Do CYP2C19 loss-of-function alleles increase the risk of adverse clinical outcomes in patients receiving clopidogrel after PCI with newer-generation drug-eluting stents?
P
Population
4,587 patients undergoing percutaneous coronary intervention (PCI) with newer-generation drug-eluting stents, receiving clopidogrel antiplatelet treatment
I
Intervention
Presence of CYP2C19 loss-of-function alleles (CYP2C19*2/*2, CYP2C19*2/*3, and CYP2C19*3/*3 - Group 3)
C
Comparator
Patients with wild-type CYP2C19*1/*1 alleles (Group 1)
O
Outcome
Composite of death and non-fatal myocardial infarction (MI) at 1-year follow-upcomposite
CYP2C19 loss-of-function alleles significantly increase the risk of cardiac death and stent thrombosis in patients treated with clopidogrel after PCI, even in the era of newer-generation drug-eluting stents.
Cite This Study
Joo et al. (2018) studied this question.