title: The impact of cytochrome P450 2C19 polymorphism on the occurrence of one-year in-stent restenosis in patients who underwent percutaneous coronary intervention: A case-match study.
abstract: OBJECTIVE
  In this case-match study, we evaluated the impact of the CYP2C19*2 polymorphism in the occurrence of in-stent restenosis during a 1-year follow-up period despite adequate dual anti-platelet therapy in Iranian patients having undergone percutaneous coronary intervention (PCI).
  
  
  METHODS
  This study, conducted at a tertiary referral heart center in Tehran, recruited 100 patients: 50 patients had in-stent restenosis after PCI during a 1-year follow-up and were compared to another 50 patients without in-stent restenosis who were individually matched according to sex. In order to evaluate the impact of the CYP2C19*2 polymorphism, case frequency matching was performed with respect to variables previously shown to be predictors of in-stent restenosis. The CYP2C19*2 polymorphism evaluated using real-time PCR methods.
  
  
  RESULTS
  Among all 100 patients (mean age=60.09 ± 10.29: 72.0% male), 89 (89%) patients had wild (CYP2C19*1/CYP2C19*1) and 11% had a heterozygous (CYP2C19*1/CYP2C19*2) genotypes, and there was no patient with a completely mutant genotype (CYP2C19*2/CYP2C19*2). Conditional logistic regression analysis showed that there was no significant association between genotype CYP2C19*1/CYP2C19*2 and the occurrence of in-stent restenosis after PCI (OR=2.5, p value=0.273).
  
  
  CONCLUSIONS
  Our findings indicated that carrying a CYP2C19*2 allele with a functional CYP2C19*1 allele had no significant association with in-stent restenosis 1 year after PCI. The antiplatelet treatment strategy for non-functional allele carriers is still a matter of controversy. Further studies with larger sample sizes are necessary to determine the prevalence of non-functional alleles in various populations and to achieve a consensus about the effective treatment strategy.
authors.affiliation: Department of Interventional Cardiology, University of Medical Sciences, Tehran Heart Center; Tehran-Iran. dr.sirus.vosoghi@gmail.com.
authors.forename: Younes
authors.initials: Y
authors.lastname: Nozari
authors.forename: Sirous
authors.initials: S
authors.lastname: Vosooghi
authors.forename: Mohammadali
authors.initials: M
authors.lastname: Boroumand
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Poorhosseini
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Nematipour
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Salarifar
authors.forename: Seyed Ebrahim
authors.initials: SE
authors.lastname: Kassaian
authors.forename: Alireza
authors.initials: A
authors.lastname: Amirzadegan
authors.forename: Mohammad
authors.initials: M
authors.lastname: Alidoosti
authors.forename: Ali Mohammad
authors.initials: AM
authors.lastname: Haji-Zeinali
authors.forename: Sepideh
authors.initials: S
authors.lastname: Saroukhani
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D016022:Case-Control Studies; D000077144:Clopidogrel; D023903:Coronary Restenosis / Q000235:genetics*; D065731:Cytochrome P-450 CYP2C19 / Q000235:genetics*; D005260:Female; D006801:Humans; D007492:Iran; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011110:Polymorphism, Genetic; D015995:Prevalence; D012042:Registries; D015607:Stents; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D065731:Cytochrome P-450 CYP2C19; D013988:Ticlopidine