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Impact of genetic variants on major bleeding after percutaneous coronary intervention based on a prospective

Jung-Joon Cha1, Hyung Joon Joo1, Jae Hyoung Park1

  • 1Division of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Korea University of College of Medicine, Seoul, South Korea.

Scientific Reports
|January 20, 2021
PubMed

Insights

Genetic variants in P2Y12 G52T may predict major bleeding risk in patients undergoing percutaneous coronary interventions. The TT variant of P2Y12 G52T significantly increases major bleeding events, offering insights for personalized antiplatelet therapy.

Area of Science:

  • Cardiovascular Genetics
  • Pharmacogenomics
  • Interventional Cardiology

Background:

  • Dual antiplatelet therapy (DAPT) is crucial after percutaneous coronary interventions (PCI).
  • Major bleeding is a significant complication of DAPT, with limited understanding of genetic predictors.
  • Identifying genetic factors associated with bleeding risk can optimize patient management.

Purpose of the Study:

  • To investigate the association between common genetic variants and major bleeding events in patients treated with DAPT after PCI.
  • To identify specific single nucleotide polymorphisms (SNPs) that predict major bleeding risk.

Main Methods:

  • Prospective analysis of 4489 patients from a multicenter registry undergoing PCI.
  • Genotyping for four SNPs: CYP2C19, ABCB1, PON1, and P2Y12 G52T.
  • Primary endpoint: Major bleeding (Bleeding Academic Research Consortium ≥3).

Main Results:

  • Allelic frequencies of ABCB1, PON1, and CYP2C19 variants did not significantly differ between bleeding and non-bleeding groups.
  • The P2Y12 G52T variant showed a significant difference in allelic frequency between groups.
  • Patients with the P2Y12 G52T TT genotype had a higher rate of major bleeding (6.4%) compared to other genotypes (adjusted HR 2.51, p=0.033).

Conclusions:

  • The P2Y12 G52T polymorphism, specifically the TT genotype, may serve as an independent predictor of major bleeding in patients after PCI.
  • This finding supports the potential for pharmacogenetic-guided antiplatelet therapy to mitigate bleeding risk.

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