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Updated: Jul 4, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Risk factors for Post-PCI cardiovascular events in coronary artery disease patients treated with clopidogrel combined

Jun Zhou1, Qiang-Sheng Wang2

  • 1Department of Cardiology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Frontiers in Pharmacology
|July 3, 2026
PubMed

Insights

CYP2C19 loss-of-function variants increase adverse events in coronary artery disease patients after PCI. Genotype-informed risk assessment may improve outcomes for patients on clopidogrel therapy.

Area of Science:

  • Pharmacogenomics
  • Cardiovascular Medicine
  • Interventional Cardiology

Background:

  • CYP2C19 loss-of-function (LOF) variants may affect clopidogrel efficacy post-PCI.
  • Prognostic impact of CYP2C19 LOF in combined risk models is not fully understood.

Purpose of the Study:

  • To assess the association between CYP2C19 functional phenotype and major adverse cardiac and cerebrovascular events (MACCE).
  • To evaluate MACCE risk in coronary artery disease (CAD) patients receiving clopidogrel-based dual antiplatelet therapy (DAPT) after PCI.

Main Methods:

  • Retrospective observational study of 280 CAD patients undergoing PCI.
  • Primary endpoint: time to first MACCE.
  • Analysis using multivariable Cox regression, logistic regression, and Kaplan-Meier.

Main Results:

  • 52 patients (18.6%) experienced MACCE during a median 32.0-month follow-up.
  • CYP2C19 LOF phenotype was independently associated with increased MACCE risk (aHR 1.74, P=0.018).
  • Lower MACCE-free survival observed in LOF carriers (log-rank P=0.007).

Conclusions:

  • CYP2C19 LOF phenotype is linked to MACCE in clopidogrel-treated CAD patients post-PCI.
  • Findings suggest integrating genotype into post-PCI risk stratification requires prospective validation.
Abstract

Keywords:
aspirinclopidogrelcoronary artery diseasedual antiplatelet therapymajor adverse cardiovascular eventspercutaneous coronary intervention

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