Effects of genetic variants on platelet reactivity and one- year clinical outcomes after percutaneous coronary intervention: A prospective multicentre registry study
- Title
- Effects of genetic variants on platelet reactivity and one- year clinical outcomes after percutaneous coronary intervention: A prospective multicentre registry study
- Author
- 임영효
- Keywords
- ANTIPLATELET THERAPY; ASIAN PATIENTS; STENT THROMBOSIS; CLOPIDOGREL; POLYMORPHISMS; CYP2C19-ASTERISK-2; CONSENSUS; IMPACT; CYP2C9-ASTERISK-3; DETERMINANTS
- Issue Date
- 2018-01
- Publisher
- NATURE PUBLISHING GROUP
- Citation
- SCIENTIFIC REPORTS, v. 8, Article no. 1229
- Abstract
- Clopidogrel is the mainstay for antiplatelet treatment after percutaneous coronary intervention (PCI). The relationship of platelet reactivity and genetic polymorphism with clinical outcomes with newer-generation drug-eluting stents is unclear. We analysed 4,587 patients for the most powerful single-nucleotide polymorphisms (CYP2C19, CYP2C9, ABCB1, PON1, and P2Y12) related to on-treatment platelet reactivity (OPR). The optimal cut-off value of high OPR for major adverse thrombotic events was 266. CYP2C19 was significantly associated with high OPR and the number of CYP2C19*R (*2 or *3) alleles was proportional to the increased risk of high OPR. Death, myocardial infarction (MI), stroke, stent thrombosis, and bleeding events were assessed during a 1-year follow-up period. Primary endpoints were death and non-fatal MI. The cumulative 1-year incidence of death and stent thrombosis was significantly higher in patients with CYP2C19*2/*2, CYP2C19*2/*3, and CYP2C19*3/*3 (Group 3) than in patients with CYP2C19*1/*1 (Group 1). Multivariate Cox proportional hazard model showed that cardiac death risk was significantly higher in Group 3 than in Group 1 (hazard ratio 2.69, 95% confidence interval 1.154-6.263, p = 0.022). No association was reported between bleeding and OPR. Thus, CYP2C19 may exert a significant impact on the prognosis of PCI patients even in the era of newer-generation drug-eluting stents.
- URI
- https://www.nature.com/articles/s41598-017-18134-yhttps://repository.hanyang.ac.kr/handle/20.500.11754/117012
- ISSN
- 2045-2322
- DOI
- 10.1038/s41598-017-18134-y
- Appears in Collections:
- COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
- Files in This Item:
- Effects of genetic variants on platelet reactivity and one- year clinical outcomes after percutaneous coronary intervention A prospective multicent...Download
- Export
- RIS (EndNote)
- XLS (Excel)
- XML