title: Correlation between the CYP2C19 phenotype status and the results of three different platelet function tests in cardiovascular disease patients receiving antiplatelet therapy: an emphasis on newly introduced platelet function analyzer-200 P2Y test.
abstract: BACKGROUND
  An association has been reported between CYP2C19 polymorphism and the altered antiplatelet activity of clopidogrel. We investigated this association using the newly introduced platelet function analyzer (PFA)-200 (INNOVANCE PFA-200 System; Siemens Healthcare, Germany) P2Y test.
  
  
  METHODS
  Polymorphisms of CYP2C19*2, *3, *17 and the degree of inhibition of platelet function were determined in 83 patients. Three different platelet function tests were used to evaluate the degree of platelet inhibition and to check the association with genotype.
  
  
  RESULTS
  The post-procedure PFA-200 values of extensive metabolizers (EM) patients (285.3±38.8) were higher than those of intermediate metabolizers (IM) and poor metabolizers (PM) patients (227.7±98.3 and 133.7±99.2, respectively; P=0.024). Light transmittance aggregometry (LTA) and the VerifyNow system showed that the post-procedure values for EM patients were lower than those of IM and PM patients (LTA: 24.4±15.7, 34.1±17.6, and 42.2±16.9, respectively, P<0.001; VerifyNow: 133.2±60.5, 171.5±42.6, and 218.7±59.3, respectively, P<0.001). The high residual platelet reactivity (HPR) rates were significantly different among the EM, IM, and PM groups using PFA-200 (PM:IM:EM=82.4:40.6:11.8, P<0.001).
  
  
  CONCLUSIONS
  Approximately, 59.0% of Korean patients with cardiovascular disease receiving clopidogrel had CYP2C19 loss-of-function genotypes classified as IM or PM, and the frequency was similar to the data from Asian people. The PFA-200, LTA, and VerifyNow platelet function tests revealed evidence of a significant association between the efficacy of clopidogrel and CYP2C19 genotypes.
authors.affiliation: Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Shuhua
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Jae Lim
authors.initials: JL
authors.lastname: Choi
authors.affiliation: Department of Cardiology, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Long Zhe
authors.initials: LZ
authors.lastname: Guo
authors.affiliation: Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Ri Young
authors.initials: RY
authors.lastname: Goh
authors.affiliation: Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Bo Ram
authors.initials: BR
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Kwang Sook
authors.initials: KS
authors.lastname: Woo
authors.affiliation: Department of Cardiology, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Moo Hyun
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea. jyhan@dau.ac.kr.
authors.forename: Jin Yeong
authors.initials: JY
authors.lastname: Han
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy*; D000077144:Clopidogrel; D065731:Cytochrome P-450 CYP2C19 / Q000235:genetics* / Q000378:metabolism; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010979:Platelet Function Tests / Q000295:instrumentation; D011110:Polymorphism, Genetic; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D013988:Ticlopidine
keywords: CYP2C19; Clopidogrel; LTA; PFA-200; VerifyNow