Why the study?
Does simultaneous carriage of CYP2C19*2 and *17 alleles increase the risk of stent thrombosis in ACS patients treated with clopidogrel?
Does simultaneous carriage of CYP2C19*2 and *17 alleles increase the risk of stent thrombosis in ACS patients treated with clopidogrel?
Patients with ACS and simultaneous carriage of CYP2C19*2 and *17 alleles have a higher risk of stent thrombosis when treated with clopidogrel, suggesting they act as poor metabolizers.
CYP2C19 genotyping should not yet guide clopidogrel therapy post-stenting; leaves open need for prospective validation in larger cohorts.
Aim. To assess the association of efficacy and safety endpoints with simultaneous carriage of polymorphic variants of the gene CYP2C19: rs4244285 (*2), and rs12248560 (*17) in treatment with clopidogrel. Material and methods. In the study, 289 patients included, from large cities of Siberia, underwent coronary stenting for acute coronary syndrome. All participants were assessed for alleles CYP2C19*2, *3, *17, and clinical outcomes were followed for 30 days (thrombotic complications, bleedings). Results. It was found that simultaneous carriage of CYP2C19*2 and CYP2C19*17 alleles is associated with the risk of serious adverse events development of thrombotic origin comparing to the absence of such polymorphism carriage (p=0,016), and with general adverse events risk related to insufficiency of clopidogrel action (р=0,046). Conclusion. According to the study results, subjects with the *2/*17 carriage should be classified to a delayed clopidogrel metabolism group, as in the group definite and probable stent thrombosis were found significantly more prevalent.
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Zelenskaya et al. (2017) studied this question.
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