Prognostic Implication of CYP2C19 Genotype According to Clinical Risk Stratification After Drug‐Eluting Stent Implantation

Figures

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  Figure 1. Cumulative incidence of (a) MACE and (b) major bleeding at 3 years based on CYP2C19 phenotype. Cumulative incidence of (a) MACE (a composite of cardiac death, myocardial infarction, and stent thrombosis) and (b) major bleeding (BARC type 3‐ 5) was compared between the rapid metabolizer (RM) or normal metabolizer (NM) vs. intermediate metabolizer (IM) or poor metabolizer (PM) over a 3‐year follow‐up period. BARC, Bleeding Academic Research Consortium; CI, confidence interval CYP2C19, hepatic cytochrome P450;HR, hazard ratio; MACE, major adverse cardiovascular event.

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  Figure 2. (a) CHADS‐P2A2RC and (b) TRS 2°P scores: variables, distribution, and cumulated incidence of clinical events. CABG, coronary bypass graft; CAD, coronary artery disease; CHF, congestive heart failure; TRS 2°P, thrombolysis in myocardial infarction (TIMI) risk score for secondary prevention.

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  Figure 3. Cumulative incidence of (a) MACE, (b) cardiac death, and (c) major bleeding at 3 years according to CHADS‐P2A2RC and CYP2C19 phenotype. Cumulative incidence of (a) MACE (a composite of cardiac death, myocardial infarction, and stent thrombosis), (b) cardiac death, and (c) major bleeding (BARC type 3 or 5) was compared across the four groups stratified by CHADS‐P2A2RC score (high [≥ 4] vs. low [≤ 3]) and CYP2C19 phenotype (rapid metabolizer [RM] or normal metabolizer [NM] vs. intermediate metabolizer [IM] or poor metabolizer [PM]) over a 3‐year follow‐up period. BARC, Bleeding Academic Research Consortium; CYP2C19, hepatic cytochrome P450; MACE, major adverse cardiovascular event.

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  Figure 4. Cumulative incidence of (a) MACE, (b) cardiac death, and (c) major bleeding at 3 years based on TRS 2°P score and CYP2C19 phenotype. Cumulative incidence of (a) MACE (a composite of cardiac death, myocardial infarction, and stent thrombosis), (b) cardiac death, and (c) major bleeding (BARC type 3 or 5) was compared across the four groups stratified by TRS 2°P score (high [≥ 3] vs. low [≤ 2]) and CYP2C19 phenotype (rapid metabolizer [RM] or normal metabolizer [NM] vs. intermediate metabolizer [IM] or poor metabolizer [PM]) over a 3‐year follow‐up period. BARC, Bleeding Academic Research Consortium; CYP2C19, hepatic cytochrome P450; MACE, major adverse cardiovascular event; TRS 2°P, thrombolysis in myocardial infarction (TIMI) risk score for secondary prevention.

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  Figure 5. Prognostic implication of CYP2C19 phenotype according to clinical risk stratification and disease entity. Adjustment was performed by variables such as sex, body mass index, dyslipidemia, and the use of β‐blocker, angiotensin blocker, and statin. CI, confidence interval; CYP2C19, hepatic cytochrome P450; HR, hazard ratio; IM, intermediate metabolizer; NM, normal metabolizer; PM, poor metabolizer; RM, rapid metabolizer; TRS 2°P, thrombolysis in myocardial infarction (TIMI) risk score for secondary prevention.