Key result
The CYP2C19*2 (G681A) polymorphism was an independent risk factor for high on-treatment platelet reactivity (OR 2.837) in Han Chinese patients with coronary heart disease receiving clopidogrel.
Why the study?
Does the CYP2C19*2 polymorphism increase the risk of high on-treatment platelet reactivity in Han Chinese patients with coronary heart disease receiving clopidogrel?
Observational (n=146)
No
Does the CYP2C19*2 polymorphism increase the risk of high on-treatment platelet reactivity in Han Chinese patients with coronary heart disease receiving clopidogrel?
Odds Ratio: 2.837 (95% CI 1.246–6.458)
p-value: p=<0.05
In Han Chinese patients with coronary heart disease, the CYP2C19*2 A allele is significantly associated with high on-treatment platelet reactivity to clopidogrel, though it was not linked to recurrent MACEs in this small cohort.
May support CYP2C19 testing in Han Chinese on clopidogrel; leaves open whether guided therapy improves outcomes.
To investigate the genotype frequencies of cytochrome P450, family2, subfamily C, polypeptide19 (CYP2C19); P2Y12 receptor; and glycoprotein IIIa polymorphisms in patients with coronary heart disease and their impact on clopidogrel responsiveness and major adverse cardiac events (MACEs).A total of 146 coronary heart disease patients of Han ethnicity, on a clopidogrel regimen, were enrolled. Polymerase chain reaction and DNA sequencing were used to detect the genotype and allelic frequencies of CYP2C19 ((*)2,(*)3,(*)17), P2Y12 (C34T, G52T, T744C) and GPIIIa (T1565C) polymorphisms. Clinical and laboratory data were compared between the high on-treatment platelet reactivity (HTPR) versus normal groups.HTPR was identified in 35 (24%) patients. CYP2C19(*)2 (G681A) polymorphism was found to be significantly associated with HTPR (P < 0.05). A allele frequencies were significantly higher in the HTPR group versus the normal group (P < 0.05). On logistic regression analysis, CYP2C19(*)2 (G681A) polymorphism was found to be an independent risk factor associated with HTPR. No link could be established between genetic polymorphisms and recurrence of MACEs, or between HTPR and recurrence of MACEs.The genetic polymorphisms in CYP2C19(*)2 were closely associated with HTPR. The frequency of the A allele of CYP2C19(*)2 was significantly associated with HTPR, with A allele carriers being more likely to develop HTPR.
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Ou et al. (2016) conducted an observational in Coronary heart disease (n=146). CYP2C19*2 (G681A) polymorphism vs. Wild-type CYP2C19*2 was evaluated on High on-treatment platelet reactivity (HTPR) (OR 2.837, 95% CI 1.246-6.458, p=<0.05). The CYP2C19*2 (G681A) polymorphism was an independent risk factor for high on-treatment platelet reactivity (OR 2.837) in Han Chinese patients with coronary heart disease receiving clopidogrel.
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