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Impact of CYP2C19 polymorphism on platelet function tests and coagulation and inflammatory biomarkers in patients

Koichi Kaikita1, Takamichi Ono, Satomi Iwashita

  • 1Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University.

Journal of Atherosclerosis and Thrombosis
|October 4, 2013
PubMed

Insights

Platelet function tests can identify patients with CYP2C19 reduced-function gene variants who have a higher risk of cardiovascular events. These tests help monitor the effectiveness of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI).

Area of Science:

  • Pharmacogenomics
  • Cardiovascular Medicine
  • Clinical Biochemistry

Background:

  • Patients with reduced-function CYP2C19 alleles on dual antiplatelet therapy (DAPT) show impaired platelet inhibition and increased event risk.
  • Understanding the impact of CYP2C19 variants is crucial for optimizing antiplatelet therapy in patients undergoing percutaneous coronary intervention (PCI).

Purpose of the Study:

  • To investigate the influence of CYP2C19 gene variants on platelet function, coagulation, and inflammatory biomarkers in patients undergoing elective PCI.
  • To assess the utility of platelet function tests in identifying carriers of CYP2C19 reduced-function alleles.

Main Methods:

  • Prospective, observational, multicenter study of 104 Japanese patients undergoing elective PCI.
  • Analysis of CYP2C19 genotype, platelet function (light transmittance aggregometry, VerifyNow P2Y12), coagulation and inflammatory biomarkers, and hs-TnT levels at multiple time points post-PCI.

Main Results:

  • 65% of patients were carriers of the CYP2C19 reduced-function allele.
  • Carriers exhibited significantly higher on-clopidogrel platelet aggregation (PA) and platelet reactivity index (PRI) compared to non-carriers.
  • No significant differences were observed in coagulation, inflammatory biomarkers, or hs-TnT levels between carriers and non-carriers.

Conclusions:

  • Platelet function tests, specifically on-clopidogrel PA and PRI, are effective in identifying carriers of CYP2C19 reduced-function gene variants.
  • These tests are valuable for monitoring DAPT efficacy in patients undergoing elective PCI, unlike coagulation or inflammatory biomarkers.
Abstract

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