Impact of the CYP2C19*17 polymorphism on the clinical outcome of clopidogrel therapy in Asian patients undergoing percutaneous coronary intervention.
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.
aDepartment of Cardiology, Daejeon St. Mary's Hospital bDepartment of Cardiology, Yeouido St. Mary's Hospital cDepartment of Cardiology, Uijeongbu St. Mary's Hospital dDepartment of Cardiology, Seoul St. Mary's Hospital eDepartment of Cardiology, Incheon St. Mary's Hospital fDepartment of Cardiology, St. Vincent's Hospital gDepartment of Cardiology, St. Paul's Hospital hDepartment of Cardiology, Bucheon St. Mary's Hospital, The Catholic University of Korea iDepartment of Pharmacology, PharmacoGenomics Research Center, College of Medicine jDepartment of Clinical Pharmacology, Busan Paik Hospital, Inje University, Busan, Korea.
Mahn-Won
MW
Park
Sung Ho
SH
Her
Ho-Sook
HS
Kim
Yun-Seok
YS
Choi
Chul-Soo
CS
Park
Yoon-Seok
YS
Koh
Hun-Jun
HJ
Park
Pum-Joon
PJ
Kim
Chan Joon
CJ
Kim
Doo Soo
DS
Jeon
Dong Il
DI
Shin
Suk Min
SM
Seo
Ki-Dong
KD
Yoo
Dong Bin
DB
Kim
Hee Yeol
HY
Kim
Jong Min
JM
Lee
Wook-Sung
WS
Chung
Ki-Bae
KB
Seung
Jae-Gook
JG
Shin
Kiyuk
K
Chang
D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics*; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000077144:Clopidogrel; D065731:Cytochrome P-450 CYP2C19; D004334:Drug Administration Schedule; D008040:Genetic Linkage; D014644:Genetic Variation; D005838:Genotype; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology; D017202:Myocardial Ischemia / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011110:Polymorphism, Genetic; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D013988:Ticlopidine; D001241:Aspirin