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Impact of genetic variants on clinical outcome after percutaneous coronary intervention in elderly patients

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

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

Aging
|March 12, 2021
PubMed

Insights

Genetic variants impact outcomes in elderly patients undergoing percutaneous coronary intervention (PCI). Poor CYP2C19 metabolizers face higher risks, while P2Y12 G52T TT genotypes increase major bleeding events.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacogenomics
  • Geriatric Cardiology

Background:

  • Elderly patients undergoing percutaneous coronary intervention (PCI) exhibit increased risks for ischemic and bleeding complications.
  • Limited research exists on the influence of genetic factors on clinical outcomes in this demographic.

Purpose of the Study:

  • To investigate the impact of specific genetic variants on clinical outcomes in elderly patients (≥75 years) treated with PCI.
  • To analyze correlations between CYP2C19 and P2Y12 receptor gene polymorphisms and adverse cardiovascular and bleeding events.

Main Methods:

  • Prospective analysis of 811 elderly patients from a multicenter registry undergoing PCI.
  • Evaluation of single-nucleotide polymorphisms in CYP2C19 and P2Y12 receptor gene G52T.
  • Assessment of primary (myocardial infarction, death) and secondary endpoints including major bleeding (BARC ≥3).

Main Results:

  • Patients with poor CYP2C19 metabolizer status showed a significantly higher risk for the primary composite endpoint (MI/death) and secondary endpoints (death, cardiac death).
  • The TT genotype group for the P2Y12 G52T polymorphism exhibited a significantly higher incidence of major bleeding events.

Conclusions:

  • CYP2C19 poor metabolizer status and P2Y12 G52T TT genotype are potential predictors of adverse clinical outcomes in elderly PCI patients.
  • Pharmacogenetic profiling may aid in risk stratification and personalized treatment strategies for older adults undergoing PCI.

Keywords:
P2Y12 receptor gene polymorphismclinical outcomecoronary artery diseasecytochrome P-450 CYP2C19elderly

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