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September 10, 2010European Heart JournalOpen Access

CYP2C19*2 and CYP2C9*3 alleles are associated with stent thrombosis: a case-control study

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Key result

Carriage of the CYP2C19*2 (OR 1.7; 95% CI 1.0-2.6) and CYP2C9*3 (OR 2.4; 95% CI 1.0-5.5) variant alleles was significantly associated with increased risk of stent thrombosis after PCI.

Why the study?

Does the carriage of CYP2C19*2 and CYP2C9*3 alleles increase the risk of stent thrombosis in patients receiving clopidogrel and aspirin after PCI?

Population

596 patients who underwent percutaneous coronary intervention and were treated with dual antiplatelet…

Comparison

Carriage of genetic variants involved in… vs Non-carriers of the respective genetic variants.

Design

Case-control

Follow-up

1 year

Authors

AHAnkie M. HarmszeJWJochem W. van WerkumJBJurriën M. ten Berg

Discussion

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Overview

CYP2C19*2 and CYP2C9*3 alleles were associated with stent thrombosis; leaves open whether genotyping improves outcomes after PCI.

Study Design

Type

Case-Control (n=596)

Structured PICO

Does the carriage of CYP2C19*2 and CYP2C9*3 alleles increase the risk of stent thrombosis in patients receiving clopidogrel and aspirin after PCI?

P
Population
596 subjects (176 cases with stent thrombosis and 420 controls without adverse events within 1 year) on dual antiplatelet therapy after stenting.
E
Exposure
Carriage of genetic variants involved in clopidogrel absorption, metabolism (including CYP2C19*2 and CYP2C9*3), and pharmacodynamics.
C
Comparator
Non-carriers of the respective genetic variants.
O
Outcome
Occurrence of stent thrombosis (acute, subacute, or late).hard clinical

Main Result

Odds Ratio: 1.7 (95% CI 1–2.6)

p-value: p=0.018

Carriage of loss-of-function alleles CYP2C19*2 and CYP2C9*3 is associated with an increased risk of stent thrombosis in patients treated with clopidogrel after PCI.

Cite This Study

Harmsze et al. (2010) conducted a case-control in Stent thrombosis after percutaneous coronary intervention (n=596). CYP2C19*2 and CYP2C9*3 variant alleles vs. Absence of variant alleles was evaluated on Stent thrombosis (OR 1.7, 95% CI 1.0-2.6, p=0.018). Carriage of the CYP2C19*2 (OR 1.7; 95% CI 1.0-2.6) and CYP2C9*3 (OR 2.4; 95% CI 1.0-5.5) variant alleles was significantly associated with increased risk of stent thrombosis after PCI.

synapsesocial.com/papers/6a5fa7bb9e99e7407a7eb62bhttps://doi.org/10.1093/eurheartj/ehq321
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Besides CYP2C19*2, the variant allele CYP2C9*3 is associated with higher on-clopidogrel platelet reactivity in patients on dual antiplatelet therapy undergoing elective coronary stent implantation2009 · 95 citations
  2. 2Genetic Determinants of Response to Clopidogrel and Cardiovascular Events2008 · 1,730 citations
  3. 3Cytochrome P450 2C19 681G>A Polymorphism and High On-Clopidogrel Platelet Reactivity Associated With Adverse 1-Year Clinical Outcome of Elective Percutaneous Coronary Intervention With Drug-Eluting or Bare-Metal Stents2008 · 544 citations
  4. 4Cytochrome P-450 Polymorphisms and Response to Clopidogrel2008 · 2,502 citations
  5. 5Early but not late stent thrombosis is influenced by residual platelet aggregation in patients undergoing coronary interventions2009 · 108 citations