title: Personalized antiplatelet therapy according to CYP2C19 genotype after percutaneous coronary intervention: a randomized control trial.
abstract: OBJECTIVE
  The objective of this study is to compare personalized antiplatelet therapy according to CYP2C19 phenotype with conventional antiplatelet therapy in patients after percutaneous coronary intervention (PCI).
  
  
  METHODS
  A total of 600 patients with coronary artery disease (CAD) undergoing PCI randomly received a personalized antiplatelet therapy (group A; n=301) or conventional antiplatelet treatment (group B; n=299). For group A, antiplatelet therapy was performed according to CYP2C19 phenotype. For group B, the patients received conventional antiplatelet treatment without detected CYP2C19 genotype. The primary end point was compared between these two groups. This study is registered with the Chinese Clinical Trial Registry (ChiCTR-TRC-11001807).
  
  
  RESULTS
  The primary end point occurred in 27 patients assigned to conventional treatment as compared with 8 patients assigned to personalized therapy (cumulative event rate, 9.03% vs. 2.66%; P<0.01). The composite rate of death, myocardial infarction, or stroke at 180 days occurred in 3 and 18 patients in the two groups, respectively (cumulative event rate, 1.0% and 6.2%, P<0.01). The cumulative 180-day incidence of ST was significantly lower in group A than in group B (0.66% vs. 3.01%, P=0.032). The 180-day incidence of MI (0.33% vs. 3.01%, P=0.011) and death (0.33% vs. 2.34%, P=0.011) was fewer than that in control, respectively. We did not find the significant difference in bleeding events between the 2 groups.
  
  
  CONCLUSIONS
  Personalized antiplatelet therapy according to CYP2C19 genotype after PCI can significantly decrease the incidence of major adverse cardiovascular events and the risk of 180-day ST in Chinese population.
authors.affiliation: Department of Coronary Artery Disease, Heart Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, PR China. Electronic address: xiangxie999@sina.com.
authors.forename: Xiang
authors.initials: X
authors.lastname: Xie
authors.forename: Yi-Tong
authors.initials: YT
authors.lastname: Ma
authors.forename: Yi-Ning
authors.initials: YN
authors.lastname: Yang
authors.forename: Xiao-Mei
authors.initials: XM
authors.lastname: Li
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Zheng
authors.forename: Xiang
authors.initials: X
authors.lastname: Ma
authors.forename: Zhen-Yan
authors.initials: ZY
authors.lastname: Fu
authors.lastname: Ba Bayinsilema
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Zi-Xiang
authors.initials: ZX
authors.lastname: Yu
authors.forename: You
authors.initials: Y
authors.lastname: Chen
authors.forename: Bang-Dang
authors.initials: BD
authors.lastname: Chen
authors.forename: Fen
authors.initials: F
authors.lastname: Liu
authors.forename: Ying
authors.initials: Y
authors.lastname: Huang
authors.forename: Cheng
authors.initials: C
authors.lastname: Liu
authors.forename: Gulinaer
authors.initials: G
authors.lastname: Baituola
mesh_terms: D000368:Aged; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics*; D044466:Asian People / Q000235:genetics*; D000077144:Clopidogrel; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000235:genetics / Q000601:surgery; D065731:Cytochrome P-450 CYP2C19; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000639:trends*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D057285:Precision Medicine / Q000379:methods*; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D013988:Ticlopidine
keywords: CYP2C19; Clopidogrel; Genetics; Personalized medicine; Stent thrombosis