CYP2C19 and Nongenetic Factors Predict Poor Responsiveness to Clopidogrel Loading dose after Coronary Stent Implantation
- 9 September 2008
- journal article
- clinical trial
- Published by Taylor & Francis in Pharmacogenomics
- Vol. 9 (9) , 1251-1259
- https://doi.org/10.2217/14622416.9.9.1251
Abstract
Aims: To investigate an association of responsiveness to clopidogrel loading dose with genotypes of cytochrome P450 (CYP) 2C19, other CYP isozymes and nongenetic factors in patients with coronary artery disease. Materials & methods: Genotyping for CYP2C19 (*2, *3 and *17), CYP3A4*1B and CYP3A5*3 variants was performed in patients (n = 237) who underwent percutaneous coronary intervention. Adenosine diphosphate-induced platelet aggregation was determined after first administration of 600 mg clopidogrel. Results: CYP2C19*2 carriers showed significantly increased residual platelet aggregation (RPA) (OR: 4.6; 95% CI: 2.5–8.7; p < 0.0001) compared with noncarriers. All other polymorphisms had no influence on RPA. For the development of a risk score for better prediction of RPA, CYP2C19*2 genotype and previously identified nongenetic risk factors (age >65 years, Type 2 diabetes mellitus, decreased left ventricular function, renal failure and acute coronary syndrome) were analyzed. Multivariable logistic regress...Keywords
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