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Lack of association between peri-procedural myocardial damage and CYP2C19 gene variant in elective percutaneous

Hiromi Yoshimura1, Koichi Kaikita2, Takamichi Ono1

  • 1Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.

Heart and Vessels
|May 1, 2014
PubMed

Insights

Peri-procedural myocardial damage (MD) after percutaneous coronary intervention (PCI) is not significantly linked to clopidogrel platelet aggregation or CYP2C19 gene variants. Older age, high hemoglobin A1c, and longer stent length were independent predictors of MD.

Area of Science:

  • Cardiology
  • Pharmacogenomics
  • Interventional Cardiology

Background:

  • Peri-procedural myocardial damage (MD) following percutaneous coronary intervention (PCI) increases risks of major in-hospital complications and adverse clinical events.
  • Understanding factors influencing MD is crucial for improving patient outcomes after PCI.

Purpose of the Study:

  • To evaluate the impact of on-clopidogrel platelet aggregation and CYP2C19-reduced-function gene variants on PCI-related myocardial damage.
  • To identify independent predictors of myocardial damage in patients undergoing elective PCI.

Main Methods:

  • Serum high-sensitive troponin T (hs-TnT) levels, CYP2C19 genotype, and on-clopidogrel platelet aggregation (PA) were measured in 91 patients undergoing stent implantation.
  • A control group of 30 patients underwent coronary angiography (CAG) without PCI.
  • Blood samples were collected pre- and 24-hours post-procedure; patients were stratified into high and low MD groups based on hs-TnT levels.

Main Results:

  • Serum hs-TnT levels significantly increased 24 hours post-PCI compared to baseline (p < 0.001).
  • Simple logistic regression showed MD correlated with age, estimated GFR, hemoglobin A1c, baseline hs-TnT, and stent length.
  • Multiple logistic regression identified old age, high hemoglobin A1c, and long stent length as independent predictors of MD, but not CYP2C19 reduced-function allele or high on-clopidogrel PA.

Conclusions:

  • Elective PCI-related myocardial damage is not significantly associated with high on-clopidogrel platelet aggregation or CYP2C19 reduced-function alleles.
  • Age, hemoglobin A1c levels, and stent length are key independent predictors of peri-procedural myocardial damage in patients undergoing elective PCI.

Keywords:
Angina pectorisBlood coagulationCoronary artery diseasePlateletsThrombosis

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