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May 31, 2011Heart

Variability in on-treatment platelet reactivity explained by CYP2C19*2 genotype is modest in clopidogrel pretreated patients undergoing coronary stenting

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Why the study?

Does CYP2C19*2 genotype explain the variability in on-treatment platelet reactivity in clopidogrel pretreated patients undergoing elective coronary stenting?

Population

1069 clopidogrel pretreated patients undergoing elective coronary stenting

Design

Cohort

Authors

HBHeleen BoumanAHAnkie M. HarmszeJWJochem W. van Werkum

Discussion

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Overview

CYP2C19*2 testing alone may not predict clopidogrel response; leaves open contributions of other genetic and clinical factors to platelet reactivity variability.

Structured PICO

Does CYP2C19*2 genotype explain the variability in on-treatment platelet reactivity in clopidogrel pretreated patients undergoing elective coronary stenting?

P
Population
1069 clopidogrel pretreated patients undergoing elective coronary stenting
I
Intervention
CYP2C19*2 genotyping and platelet function testing
O
Outcome
Relative contribution of CYP2C19*2 genotype to high on-treatment platelet reactivity (HPR) measured by 5 and 20 μmol/l ADP-induced LTA, PlateletWorks assay, and VerifyNow P2Y12 assaysurrogate

While the CYP2C19*2 loss-of-function polymorphism is associated with high on-treatment platelet reactivity, it explains only a modest portion of the interindividual variability in clopidogrel response.

Cite This Study

Bouman et al. (2011) studied this question.

synapsesocial.com/papers/6a73a23f9d09e2fbac279dcahttps://doi.org/10.1136/hrt.2010.220509
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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. 2Relationship Between CYP2C19 Loss-of-Function Polymorphism and Platelet Reactivities With Clopidogrel Treatment in Japanese Patients Undergoing Coronary Stent Implantation2013 · 32 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 · 543 citations
  4. 4Genotyping, Platelet Activation, and Cardiovascular Outcome in Patients after Percutaneous Coronary Intervention: Two Pieces of the Puzzle of Clopidogrel Resistance2017 · 14 citations
  5. 5The influence of CYP 2C19*2 polymorphism on platelet function testing during single antiplatelet treatment with clopidogrel2011 · 51 citations