Key result
The presence of at least one CYP2C19*2 allele was significantly associated with an increased risk of definite stent thrombosis compared to wild-type (2.4% vs 0.75%) in Chinese patients post-PCI.
Why the study?
Does the CYP2C19*2 polymorphism increase the risk of definite stent thrombosis in Chinese patients with coronary artery disease undergoing PCI and receiving clopidogrel?
Observational (n=1,738)
Does the CYP2C19*2 polymorphism increase the risk of definite stent thrombosis in Chinese patients with coronary artery disease undergoing PCI and receiving clopidogrel?
Absolute Event Rate: 2.4% vs 0.75%
The CYP2C19*2 polymorphism is associated with a significantly higher risk of definite stent thrombosis in Chinese patients receiving clopidogrel after PCI.
May support CYP2C19 testing in Chinese post-PCI patients on clopidogrel; leaves open whether it improves outcomes.
This study investigated the relationship between the cytochrome P450 2C19 (CYP2C19) *2 polymorphism (681A) and definite stent thrombosis (ST) in patients undergoing percutaneous coronary intervention (PCI) and receiving clopidogrel (75 mg/day, orally). The CYP2C19*2 polymorphism status of 1738 Chinese patients with coronary artery disease was examined. The primary endpoint was the occurrence of definite ST during the 180-day follow-up period. The presence of at least one CYP2C19*2 allele was significantly associated with increased ST risk (19 CYP2C19*2/*2 or *1/*2 patients [2.4%] versus seven homozygous wild-type CYP2C19*1/*1 patients [0.75%]). The risk of definite ST was highest in patients with the CYP2C19*2/*2 genotype. The CYP2C19*2 genotype is associated with an increased risk of definite ST following coronary stent placement among Chinese patients with coronary artery disease receiving clopidogrel.
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Luo et al. (2011) conducted an observational in Coronary artery disease (n=1,738). CYP2C19*2 polymorphism vs. Homozygous wild-type CYP2C19*1/*1 was evaluated on Occurrence of definite stent thrombosis (ST). The presence of at least one CYP2C19*2 allele was significantly associated with an increased risk of definite stent thrombosis compared to wild-type (2.4% vs 0.75%) in Chinese patients post-PCI.