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Title: | CYP2C19* 2 genetic polymorphism and incidence of in-stent restenosis in patients on clopidogrel : a matched case-control study |
Authors: | Osama, Sara Wirth, Francesca Zahra, Graziella Barbara, Christopher Xuereb, Robert G. Camilleri, Liberato Azzopardi, Lilian M. |
Keywords: | Clopidogrel Coronary arteries -- Stenosis Chromosome polymorphism Pharmacogenetics Genetic polymorphisms Cardiovascular Agents |
Issue Date: | 2021 |
Publisher: | The Gruyter |
Citation: | Osama, S., Wirth, F., Zahra, G., Barbara, C., Xuereb, R. G., Camilleri, L., & Azzopardi, L. M. (2021). CYP2C19* 2 genetic polymorphism and incidence of in-stent restenosis in patients on clopidogrel: A matched case-control study. Drug Metabolism and Personalized Therapy, DOI: 10.1515/dmpt-2021-0160. |
Abstract: | Objectives
The cytochrome P450 2C19*2 (CYP2C19*2) genetic polymorphism is associated with reduced clopidogrel bioactivation, increasing the risk of atherothrombotic complications after percutaneous coronary intervention (PCI). In-stent restenosis (ISR) is a complication that limits the long-term prognosis of PCI. The aim was to investigate the association between presence of the CYP2C19*2 allele and ISR within one-year after PCI in patients prescribed dual antiplatelet therapy with aspirin and clopidogrel. Methods Sixty patients with angiographically-confirmed drug eluting stent (DES)-ISR within 12 months post-PCI when on DAPT with aspirin and clopidogrel were retrospectively identified (Cases). Another 60 patients with no documented ISR post-PCI in the study period (Controls) were case-matched for age, gender, ethnicity, diabetes mellitus and estimated glomerular filtration rate value, and were invited for CYP2C19*2 genotyping. The association between presence of the CYP2C19*2 allele and ISR was analysed using the Fisher’s Exact test and binary logistic regression. Results Twenty-six (43.3%) cases and 5 (8.3%) controls were carriers of one or two CYP2C19*2 alleles. As to non-carrier status of the CYP2C19*2 allele, 34 (56.7%) cases and 55 (91.7%) controls were identified. The association between CYP2C19*2 carrier status and DES-ISR within one-year post-PCI was statistically significant (p<0.001) in both the univariate and multivariate analysis. Conclusions The proportion of patients who were carriers of one or two CYP2C19*2 alleles who presented with DES-ISR within one-year post-PCI while on clopidogrel was significantly higher compared to patients with no documented ISR. |
URI: | https://www.um.edu.mt/library/oar/handle/123456789/85035 |
Appears in Collections: | Scholarly Works - FacM&SPha Scholarly Works - FacSciSOR |
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File | Description | Size | Format | |
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10.1515_dmpt-2021-0160.pdf Restricted Access | 297.33 kB | Adobe PDF | View/Open Request a copy |
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