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Published on: April 1, 2019

CYP2C19*2 and CYP2C9*3 alleles are associated with stent thrombosis: a case-control study

Ankie M Harmsze1, Jochem W van Werkum, Jurriën M Ten Berg

  • 1Department of Clinical Pharmacy, St Antonius Hospital, PO Box 2500, Nieuwegein 3430 EM, The Netherlands. a.harmsze@antoniusziekenhuis.nl

European Heart Journal
|September 14, 2010
PubMed

Insights

Genetic variations in CYP2C19*2 and CYP2C9*3 increase the risk of stent thrombosis (ST) after percutaneous coronary interventions (PCI). These findings highlight the importance of genetic testing for patients undergoing PCI and receiving clopidogrel therapy.

Area of Science:

  • Pharmacogenomics
  • Cardiovascular Medicine
  • Interventional Cardiology

Background:

  • Stent thrombosis (ST) remains a serious complication following percutaneous coronary interventions (PCI), despite dual antiplatelet therapy.
  • Clopidogrel efficacy can be influenced by genetic variations affecting its absorption, metabolism, and pharmacodynamics.

Purpose of the Study:

  • To investigate the association between specific gene variations and the occurrence of ST after PCI.
  • To determine the impact of genetic polymorphisms in clopidogrel-related genes on ST risk.

Main Methods:

  • A case-control study involving 176 patients with ST and 420 controls who underwent PCI.
  • Genotyping was performed for variants in ABCB1, CYP2C19, CYP2C9, CYP3A4, CYP3A5, and P2Y1 genes.
  • Statistical analysis was used to assess the association between genetic variants and ST occurrence.

Main Results:

  • The presence of CYP2C19*2 and CYP2C9*3 variant alleles was significantly associated with an increased risk of ST.
  • These specific genetic variants showed a stronger association with subacute ST.
  • No significant associations were found for other investigated genetic variations.

Conclusions:

  • Carriage of loss-of-function alleles CYP2C19*2 and CYP2C9*3 elevates the risk of ST post-PCI.
  • Genetic profiling may aid in identifying patients at higher risk for ST.
  • Personalized antiplatelet therapy strategies could potentially mitigate ST risk.
Abstract

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