Key result
Patients with the CYP2C19 intermediate metabolizer phenotype had higher odds of cerebral infarction versus coronary artery disease compared to extensive metabolizers (OR 1.443; 95% CI 1.086-1.918).
Why the study?
CYP2C19 genotypes and phenotypes affect cardiovascular and cerebrovascular drug metabolism, but differences in their distribution between CAD and cerebral infarction were not investigated.
Does the distribution of CYP2C19 metabolic phenotypes differ between patients with cerebral infarction and coronary artery disease?
Observational (n=1,163)
Does the distribution of CYP2C19 metabolic phenotypes differ between patients with cerebral infarction and coronary artery disease?
Odds Ratio: 1.443 (95% CI 1.086–1.918)
p-value: p=0.011
Patients with the CYP2C19 intermediate metabolizer phenotype are more likely to present with cerebral infarction than coronary artery disease compared to extensive metabolizers.
CYP2C19 IM phenotype may differ between CI and CAD; leaves open whether genotyping should guide therapy selection.
Background: Cytochrome P450 2C19 (CYP2C19) genotypes and metabolic phenotypes (extensive metabolizer (EM), intermediate metabolizer (IM), and poor metabolizer (PM)) are related to the metabolism of therapeutic drugs for cardiovascular and cerebrovascular diseases. This study aimed to investigate the differences of CYP2C19 gene polymorphism distribution between coronary artery disease (CAD) patients and cerebral infarction (CI) patients. Methods: We identified 413 CI patients, 509 CAD patients, and 241 CI+CAD patients from 2016 to 2020 and studied genotypes of CYP2C19 rs4986893 (636G>A) and rs4244285 (681G>A) polymorphisms using PCR-gene chip detection method. Differences in CYP2C19 genotypes and metabolic phenotypes between the groups were compared. To analyze the efficacy of CYP2C19 metabolic phenotypes in discriminating between cerebral infarction and coronary artery disease, multiple logistic regression analysis was conducted after adjusting for gender, age, smoking history, drinking history, hypertension, and diabetes. Results: There were significant differences in the distribution of CYP2C19 genotypes and metabolic phenotypes between CI and CAD patients. The results of multivariate logistic regression (adjusted for sex, age, smoking, drinking, hypertension, and diabetes) indicated that CYP2C19 IM phenotype (IM vs EM: OR 1.443, 95% CI: 1.086– 1.918, P =0.011) and CYP2C19 IM+PM phenotype (IM or PM vs EM: OR 1.440, 95% CI: 1.100– 1.885, P =0.008) may be indicators of CI from CAD. Conclusion: CYP2C19 EM metabolic phenotype was dominant in CAD patients, and CYP2C19 IM metabolic phenotype was dominant in CI patients. After adjusting for other confounding factors, patients with the CYP2C19 IM metabolic phenotype were more likely to develop CI than CAD.
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Shi et al. (2023) conducted an observational in Cerebral infarction and coronary artery disease (n=1,163). CYP2C19 intermediate metabolizer (IM) phenotype vs. CYP2C19 extensive metabolizer (EM) phenotype was evaluated on Cerebral infarction (discriminating CI from CAD) (OR 1.443, 95% CI 1.086-1.918, p=0.011). Patients with the CYP2C19 intermediate metabolizer phenotype had higher odds of cerebral infarction versus coronary artery disease compared to extensive metabolizers (OR 1.443; 95% CI 1.086-1.918).
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