title: The value of combining CYP2C19*2 polymorphism with classic risk factors in prediction of clinical prognosis in acute coronary syndrome patients.
abstract: OBJECTIVE
  To assess the impact of different CYP2C19*2 polymorphisms on clinical outcomes and the effects of CYP2C19*2 polymorphism on predicting clinical outcomes in association with classic risk factors in patients with acute coronary syndromes (ACS).
  
  
  METHODS
  Between July 2008 and September 2009, 497 consecutive patients with ACS who were admitted to the West China Hospital of Sichuan University were enrolled and underwent CYP2C19*2 determination. The clinical outcomes were the composite of cardiovascular death, nonfatal myocardial infarction and nonfatal stroke.
  
  
  RESULTS
  Baseline characteristics were balanced between noncarrier, heterozygous and homozygous groups of the CYP2C19*2 variant. The clinical endpoint occurred more frequently in the homozygous group (HR 4.86, CI 1.62-14.56, p = 0.005). After multivariable analysis, the CYP2C19*2 genetic variant was an independent predictor of cardiovascular events (HR 5.96, CI 1.77-20.03, p = 0.0039) as well as GRACE score and Killip class. The combination of CYP2C19*2 with GRACE score and Killip class increases the potential to predict adverse outcomes.
  
  
  CONCLUSIONS
  Homozygosity (A/A) for CYP2C19*2 mutant is an independent determinant of prognosis in patients with ACS. The combination of CYP2C19*2 polymorphism with classic risk factors may be a useful tool to predict the risk of cardiovascular events.
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
authors.forename: Shao-Di
authors.initials: SD
authors.lastname: Yan
authors.forename: Mao
authors.initials: M
authors.lastname: Chen
authors.forename: Qiao
authors.initials: Q
authors.lastname: Li
authors.forename: Xiao-Jing
authors.initials: XJ
authors.lastname: Liu
authors.forename: Yong
authors.initials: Y
authors.lastname: Peng
authors.forename: Hua
authors.initials: H
authors.lastname: Chai
authors.forename: Yuan-Ning
authors.initials: YN
authors.lastname: Xu
authors.forename: Jia-Fu
authors.initials: JF
authors.lastname: Wei
authors.forename: De-Jia
authors.initials: DJ
authors.lastname: Huang
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000235:genetics* / Q000401:mortality; D000368:Aged; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics*; D044466:Asian People / Q000235:genetics*; D002681:China / Q000453:epidemiology; D065731:Cytochrome P-450 CYP2C19; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009154:Mutation; D011110:Polymorphism, Genetic; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19