CYP2C19 PHARMACOGENETIC TESTING FOR PERSONALIZATION OF ANTIPLATELET THERAPY IN PATIENTS WITH ACUTE CORONARY SYNDROME IN ROUTINE CLINICAL PRACTICE
Aim. To study the use of CYP2C19 pharmacogenetic testing (PhGT) for personalization of antiplatelet therapy in patients with acute coronary syndrome (ACS) in routine practice.Material and methods. The study included 103 patients with ACS without indications for long-term anticoagulant therapy, which...
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| Format: | Article |
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Столичная издательская компания
2017-12-01
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| Series: | Рациональная фармакотерапия в кардиологии |
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| Online Access: | https://www.rpcardio.online/jour/article/view/1564 |
| _version_ | 1797232141365411840 |
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| author | A. I. Akhmetova E. B. Kleimenova D. A. Sychev O. V. Parshina L. P. Yashina |
| author_facet | A. I. Akhmetova E. B. Kleimenova D. A. Sychev O. V. Parshina L. P. Yashina |
| author_sort | A. I. Akhmetova |
| collection | DOAJ |
| description | Aim. To study the use of CYP2C19 pharmacogenetic testing (PhGT) for personalization of antiplatelet therapy in patients with acute coronary syndrome (ACS) in routine practice.Material and methods. The study included 103 patients with ACS without indications for long-term anticoagulant therapy, which underwent CYP2C19 PhGT aimed at antiplatelet therapy personalization.Results. According to CYP2C19 genotyping the GG, GA, AA allelic variants were detected. CYP2C19*2 PhGT revealed that genotypes GG, GA and AA were carried by 76 (73.8%), 23 (22.3%) and 4 (3.9%) patients, respectively. Initially 86 (83.5%) patients received clopidogrel, 17 (16.5%) – ticagrelor. After therapy correction based on genotype GA and AA, the proportion of ticagrelor receiving patients increased from 25.9% to 55.5% (relative risk=0.172; 95% confidence interval 0.075-0.396; p<0.001). In 40.7% of patients who were poor clopidogrel metabolizers increased clopidogrel doses during maintaining therapy can be associated with the increased risk of bleeding.Conclusion. PhGT results (detection of carriage of the CYP2C19*2 allele variant) was a significant predictor of antiplatelet therapy correction in ACS patients. Therapy personalization included the replacement of clopidogrel with ticagrelor or an increase in the clopidogrel maintenance dose to 150 mg per day, which did not affect significant clinical outcomes. |
| first_indexed | 2024-03-08T14:01:51Z |
| format | Article |
| id | doaj.art-38ce0c18e620494a9290e5e8891ebfcd |
| institution | Directory Open Access Journal |
| issn | 1819-6446 2225-3653 |
| language | English |
| last_indexed | 2024-04-24T15:55:33Z |
| publishDate | 2017-12-01 |
| publisher | Столичная издательская компания |
| record_format | Article |
| series | Рациональная фармакотерапия в кардиологии |
| spelling | doaj.art-38ce0c18e620494a9290e5e8891ebfcd2024-04-01T07:43:36ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532017-12-0113677177510.20996/1819-6446-2017-13-6-771-7751406CYP2C19 PHARMACOGENETIC TESTING FOR PERSONALIZATION OF ANTIPLATELET THERAPY IN PATIENTS WITH ACUTE CORONARY SYNDROME IN ROUTINE CLINICAL PRACTICEA. I. Akhmetova0E. B. Kleimenova1D. A. Sychev2O. V. Parshina3L. P. Yashina4Multidisciplinary Medical Center of the Bank of RussiaMultidisciplinary Medical Center of the Bank of Russia; Institute of Modern Information Technologies in Medicine, Federal Research Center “Computer Science and Control”, Russian Academy of SciencesRussian Medical Academy of Continuous Professional EducationMultidisciplinary Medical Center of the Bank of RussiaMultidisciplinary Medical Center of the Bank of Russia; Institute of Modern Information Technologies in Medicine, Federal Research Center “Computer Science and Control”, Russian Academy of SciencesAim. To study the use of CYP2C19 pharmacogenetic testing (PhGT) for personalization of antiplatelet therapy in patients with acute coronary syndrome (ACS) in routine practice.Material and methods. The study included 103 patients with ACS without indications for long-term anticoagulant therapy, which underwent CYP2C19 PhGT aimed at antiplatelet therapy personalization.Results. According to CYP2C19 genotyping the GG, GA, AA allelic variants were detected. CYP2C19*2 PhGT revealed that genotypes GG, GA and AA were carried by 76 (73.8%), 23 (22.3%) and 4 (3.9%) patients, respectively. Initially 86 (83.5%) patients received clopidogrel, 17 (16.5%) – ticagrelor. After therapy correction based on genotype GA and AA, the proportion of ticagrelor receiving patients increased from 25.9% to 55.5% (relative risk=0.172; 95% confidence interval 0.075-0.396; p<0.001). In 40.7% of patients who were poor clopidogrel metabolizers increased clopidogrel doses during maintaining therapy can be associated with the increased risk of bleeding.Conclusion. PhGT results (detection of carriage of the CYP2C19*2 allele variant) was a significant predictor of antiplatelet therapy correction in ACS patients. Therapy personalization included the replacement of clopidogrel with ticagrelor or an increase in the clopidogrel maintenance dose to 150 mg per day, which did not affect significant clinical outcomes.https://www.rpcardio.online/jour/article/view/1564acute coronary syndromepharmacogeneticscyp2c19clopidogrelticagrelorclinical guidelines |
| spellingShingle | A. I. Akhmetova E. B. Kleimenova D. A. Sychev O. V. Parshina L. P. Yashina CYP2C19 PHARMACOGENETIC TESTING FOR PERSONALIZATION OF ANTIPLATELET THERAPY IN PATIENTS WITH ACUTE CORONARY SYNDROME IN ROUTINE CLINICAL PRACTICE Рациональная фармакотерапия в кардиологии acute coronary syndrome pharmacogenetics cyp2c19 clopidogrel ticagrelor clinical guidelines |
| title | CYP2C19 PHARMACOGENETIC TESTING FOR PERSONALIZATION OF ANTIPLATELET THERAPY IN PATIENTS WITH ACUTE CORONARY SYNDROME IN ROUTINE CLINICAL PRACTICE |
| title_full | CYP2C19 PHARMACOGENETIC TESTING FOR PERSONALIZATION OF ANTIPLATELET THERAPY IN PATIENTS WITH ACUTE CORONARY SYNDROME IN ROUTINE CLINICAL PRACTICE |
| title_fullStr | CYP2C19 PHARMACOGENETIC TESTING FOR PERSONALIZATION OF ANTIPLATELET THERAPY IN PATIENTS WITH ACUTE CORONARY SYNDROME IN ROUTINE CLINICAL PRACTICE |
| title_full_unstemmed | CYP2C19 PHARMACOGENETIC TESTING FOR PERSONALIZATION OF ANTIPLATELET THERAPY IN PATIENTS WITH ACUTE CORONARY SYNDROME IN ROUTINE CLINICAL PRACTICE |
| title_short | CYP2C19 PHARMACOGENETIC TESTING FOR PERSONALIZATION OF ANTIPLATELET THERAPY IN PATIENTS WITH ACUTE CORONARY SYNDROME IN ROUTINE CLINICAL PRACTICE |
| title_sort | cyp2c19 pharmacogenetic testing for personalization of antiplatelet therapy in patients with acute coronary syndrome in routine clinical practice |
| topic | acute coronary syndrome pharmacogenetics cyp2c19 clopidogrel ticagrelor clinical guidelines |
| url | https://www.rpcardio.online/jour/article/view/1564 |
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