Example：10.1021/acsami.1c06204 or Chem. Rev., 2007, 107, 2411-2502
Clinical Outcomes after Percutaneous Coronary Intervention Over Time on the Basis of CYP2C19 Polymorphisms. Journal of Cardiovascular Pharmacology (IF3.105), Pub Date : 2021-10-26, DOI: 10.1097/fjc.0000000000001164 Yang Zhang, Xiliang Zhao, Yicong Ye, Quan Li, Yong Zeng
The aim of this study was to investigate the association between CYP2C19 gene polymorphisms and the risk of cardiovascular events in the early stage and subsequent period after percutaneous coronary intervention (PCI) among patients who received clopidogrel. Between October 2015 and January 2017, CYP2C19 genotyped patients who were treated with clopidogrel after PCI were enrolled in this study. Included patients were categorized as non-loss-of-function metabolizers (NLOFMs), intermediate metabolizers (IMs) and poor metabolizers (PMs) based on CYP2C19 genotype. The primary outcome was a composite of any-cause mortality, nonfatal myocardial infarction, nonfatal ischemic stroke and stent thrombosis occurring during exposure to clopidogrel. The rates of clinical outcome events were compared between CYP2C19 phenotypes. Landmark analyses were processed at 90 days and 1 year post-PCI. Of 1,341 patients, 161 (12.0%) had two copy of loss-of-function (LOF) alleles, 621(46.3%) had one LOF allele, and 559 (41.7%) had no LOF allele. At the 3-month follow-up, the primary outcome events were more frequent in carriers of two LOF alleles (5.6%) than in noncarriers (1.8%) (adjusted HR 2.944, 95% CI 1.184-7.321, p = 0.020). A similar finding was observed among in patients with acute coronary syndrome indications at the index PCI (adjusted HR 3.046, 95% CI 1.237-7.501, p = 0.015). These differences did not persist within the subsequent 9 months of follow-up, among either all-comers or subjects with acute coronary syndrome. In conclusion, these data demonstrate a higher risk for ischemic events in patients with two CYP2C19 LOF alleles who are prescribed clopidogrel, seen at 3 months following PCI, that is not sustained for 12 months.