Key result
Carriage of the CYP2C19*2 polymorphism in patients with acute coronary syndrome was significantly associated with a higher rate of hemodynamically significant stent stenosis (75% vs 0%, p<0.001).
Why the study?
Existing studies on the genetic basis of treatment response involving CYP2C19, CYP2C9, and CYP4F2 in acute coronary syndrome patients have yielded contradictory results.
Does the carriage of CYP2C19, CYP2C9, and CYP4F2 gene polymorphisms impact clinical outcomes and laboratory parameters in ACS patients receiving dual antiplatelet therapy?
Observational (n=59)
Yes
Does the carriage of CYP2C19, CYP2C9, and CYP4F2 gene polymorphisms impact clinical outcomes and laboratory parameters in ACS patients receiving dual antiplatelet therapy?
Absolute Event Rate: 75% vs 0%
p-value: p=<0.001
In ACS patients undergoing PCI, the CYP2C19*2 polymorphism is significantly associated with clopidogrel resistance and an increased risk of stent thrombosis, supporting the use of genetic testing to guide personalized antiplatelet therapy.
Observational CYP2C19 genotyping data in ACS are hypothesis-generating; prospective trials needed before clinical adoption.
Coronary heart disease (CHD) is one of the most common causes of death worldwide. The pharmacokinetic properties of drugs used to treat coronary heart disease depend on genetic factors, including the genotype of CYP2C19, CYP2C9 and CYP4F2. However, existing studies of the genetic basis of the response to treatment in patients with acute coronary syndrome (ACS) have contradictory results, requiring a more detailed study. Goal. In this study, we studied the distribution of the genotypes of CYP2C19*2, CYP2C9*2 and CYP4F2*3 among 59 patients diagnosed with ACS who received dual antiplatelet therapy. Methods. The polymerase chain reaction (PCR) method was used to determine the genotypes of CYP2C19, CYP2C9 and CYP4F2. A correlation analysis of the results of genotype carriage and clinical and laboratory parameters of patients was carried out. Results. The distribution of CYP2C9*2 genotypes was as follows: wild genotype (CC) was found with a frequency of 78 % (45 patients), heterozygotes (CT) — 22 % (12 patients), homozygotes (TT) were not detected. The CYP4F2*3 genotype was distributed as follows: 56.14 % (32 patients) had a wild genotype (CC), 31.5 % (18 patients) were heterozygotes with reduced enzyme activity (CT), 12.36 % (7 patients) were homozygotes for the T (TT) allele. The distribution of alleles and genotypes of CYP2C9 did not correspond to the Hardy-Weinberg equation (χ2 = 21.55; p = 0.044), while the distribution of alleles and genotypes of CYP4F2 corresponded to it (χ2 = 3.61; p = 0.0574). Conclusion. The study showed a high prevalence of the genotypes CYP2C9*2 (CT) and CYP4F2*3 (CT and TT) among patients with acute coronary syndrome. The carriage of CYP2C19*2 was significantly associated with adverse cardiovascular events in patients. These results suggest that genetic testing can provide valuable information for risk stratification and personalized treatment of patients with acute coronary syndrome
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Кантемирова et al. (2023) conducted an observational in Acute coronary syndrome (n=59). CYP2C19*2 polymorphism vs. Wild-type CYP2C19 *1/*1 genotype was evaluated on Hemodynamically significant stent stenosis (p=<0.001). Carriage of the CYP2C19*2 polymorphism in patients with acute coronary syndrome was significantly associated with a higher rate of hemodynamically significant stent stenosis (75% vs 0%, p<0.001).
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