Key result
CYP2C19*17 shows no association with 2-year major events vs wild-type after PCI.
Why the study?
The impact of the CYP2C19*17 polymorphism on clinical outcomes in Asian patients undergoing PCI and treated with clopidogrel was unknown.
Does the CYP2C19*17 polymorphism affect the risk of adverse clinical events in Asian patients taking clopidogrel after PCI?
Cohort (n=2,188)
Does the CYP2C19*17 polymorphism affect the risk of adverse clinical events in Asian patients taking clopidogrel after PCI?
The CYP2C19*17 polymorphism does not significantly impact clinical outcomes in Korean patients on clopidogrel post-PCI, primarily due to its extremely low prevalence in this population.
Answers are grounded in this paper and cite their sources.
No association seen in low-prevalence Asian post-PCI cohort; leaves open CYP2C19*17 relevance in higher-prevalence groups.
The impact of the CYP2C19*17 polymorphism on the clinical outcome in Asians undergoing percutaneous coronary intervention (PCI) is unknown. We sought to assess the long-term impact of CYP2C19*17 on the risk for adverse clinical events in 2188 Korean patients taking clopidogrel after PCI. The prevalence of the CYP2C19*17 allele [*wt/*17: 2.4% (n = 53), *17/*17: 0%] was very low. The 2-year cumulative event rates for bleeding [*wt/*17 vs. *wt/*wt: 2 vs. 2.3%; adjusted hazard ratio (HR), 1.23; 95% confidence interval (CI), 0.16-9.45], stent thrombosis (2 vs. 1.1%; HR, 3.98; 95% CI, 0.49-31.6) or composite of any death, and myocardial infarction or stroke (5.4 vs. 7.1%; HR, 1.37; 95% CI, 0.32-5.73) did not differ on the basis of the presence of CYP2C19*17. In conclusion, in our study population of Asian patients, the CYP2C19*17 polymorphism was not associated with adverse clinical outcomes after PCI because of its low prevalence, the rarity of homozygotes, and the relatively low rate of adverse clinical events.
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Park et al. (2013) conducted a cohort in Percutaneous coronary intervention (n=2,188). CYP2C19*17 polymorphism vs. CYP2C19 wild-type (wt/wt) was evaluated on Composite of any death, myocardial infarction, or stroke (HR 1.37, 95% CI 0.32-5.73). The CYP2C19*17 polymorphism was not associated with the 2-year composite risk of death, myocardial infarction, or stroke compared to wild-type in Asian patients after PCI (HR 1.37; 95% CI 0.32-5.73).
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