CYP2C19 loss-of-function alleles predicts clinical outcomes in East Asian patients with acute myocardial infarction undergoing percutaneous coronary intervention and stenting receiving clopidogrel
BackgroundCYP2C19 loss-of-function (LOF) alleles reduce the effectiveness of clopidogrel and are associated with high rates of clinical events in patients undergoing percutaneous coronary intervention (PCI) and stenting in Northeast Asians. However, the prevalence and influence of CYP2C19 LOF allele...
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.994184/full |
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| author | Yu-Wei Chen Yu-Wei Chen Yu-Wei Chen Yi-Ju Liao Wei-Chun Chang Wei-Chun Chang Tzu-Hung Hsiao Tzu-Hung Hsiao Tzu-Hung Hsiao Ching-Heng Lin Ching-Heng Lin Ching-Heng Lin Ching-Heng Lin Chiann-Yi Hsu Chiann-Yi Hsu Tsun-Jui Liu Tsun-Jui Liu Wen-Lieng Lee Wen-Lieng Lee Wen-Lieng Lee Yi-Ming Chen Yi-Ming Chen Yi-Ming Chen Yi-Ming Chen Yi-Ming Chen |
| author_facet | Yu-Wei Chen Yu-Wei Chen Yu-Wei Chen Yi-Ju Liao Wei-Chun Chang Wei-Chun Chang Tzu-Hung Hsiao Tzu-Hung Hsiao Tzu-Hung Hsiao Ching-Heng Lin Ching-Heng Lin Ching-Heng Lin Ching-Heng Lin Chiann-Yi Hsu Chiann-Yi Hsu Tsun-Jui Liu Tsun-Jui Liu Wen-Lieng Lee Wen-Lieng Lee Wen-Lieng Lee Yi-Ming Chen Yi-Ming Chen Yi-Ming Chen Yi-Ming Chen Yi-Ming Chen |
| author_sort | Yu-Wei Chen |
| collection | DOAJ |
| description | BackgroundCYP2C19 loss-of-function (LOF) alleles reduce the effectiveness of clopidogrel and are associated with high rates of clinical events in patients undergoing percutaneous coronary intervention (PCI) and stenting in Northeast Asians. However, the prevalence and influence of CYP2C19 LOF alleles in Southeast Asians remain unclear.ObjectivesThis study aims to retrospectively investigate the prevalence of CYP2C19 LOF alleles and clinical outcomes in East Asian patients taking clopidogrel and undergoing PCI.MethodsBetween June 2019 and June 2020, volunteer participants in a single medical center were consecutively selected. The genetic data of CYP2C19 were derived from the Taiwan Precision Medicine Initiative (TPMI). Patients receiving clopidogrel while undergoing PCI with stenting were retrospectively analyzed.ResultsA total of 999 patients (62.4 ± 11.1 years old, 83.7% men) were enrolled; 39.3% without the CYP2C19 LOF allele (normal metabolizers + rapid metabolizers, NM + RM); 44.9% with one LOF allele (intermediate metabolizers, IM); 15.7% with two LOF alleles (poor metabolizers, PM). The incidence of stroke was higher in the PM subgroup compared to the NM + RM subgroup or IM subgroup in patients presenting with acute myocardial infarction (AMI). The 1-year major adverse cardiac and cerebrovascular events (MACCE)-free survival rates in all participants were similar among the three groups. However, in the AMI group, the 1-year MACCE-free survival rates were significantly lower in the PM subgroup compared to the NM + RM subgroup or IM subgroup.ConclusionIn East Asians presenting with AMI, CYP2C19 PM was associated with deleterious cardiovascular outcomes and stroke. Our results reinforce the crucial role of preemptive CYP2C19 genotyping in East Asian AMI patients receiving clopidogrel treatment. |
| first_indexed | 2024-04-11T22:28:20Z |
| format | Article |
| id | doaj.art-49fb0c225f554ca28946f74e4a0ab014 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-11T22:28:20Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-49fb0c225f554ca28946f74e4a0ab0142022-12-22T03:59:36ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-08-01910.3389/fcvm.2022.994184994184CYP2C19 loss-of-function alleles predicts clinical outcomes in East Asian patients with acute myocardial infarction undergoing percutaneous coronary intervention and stenting receiving clopidogrelYu-Wei Chen0Yu-Wei Chen1Yu-Wei Chen2Yi-Ju Liao3Wei-Chun Chang4Wei-Chun Chang5Tzu-Hung Hsiao6Tzu-Hung Hsiao7Tzu-Hung Hsiao8Ching-Heng Lin9Ching-Heng Lin10Ching-Heng Lin11Ching-Heng Lin12Chiann-Yi Hsu13Chiann-Yi Hsu14Tsun-Jui Liu15Tsun-Jui Liu16Wen-Lieng Lee17Wen-Lieng Lee18Wen-Lieng Lee19Yi-Ming Chen20Yi-Ming Chen21Yi-Ming Chen22Yi-Ming Chen23Yi-Ming Chen24Cardiovascular Center, Taichung Veterans General Hospital, Taichung, TaiwanInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, TaiwanDepartment of Pharmacy, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Cardiology, Feng Yuan Hospital, Ministry of Health and Welfare, Taichung, TaiwanDepartment of Life Science, Tunghai University, Taichung, TaiwanDepartment of Medical Research, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Public Health, Fu Jen Catholic University, New Taipei City, TaiwanInstitute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, TaiwanDepartment of Medical Research, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Public Health, Fu Jen Catholic University, New Taipei City, Taiwan0Institute of Public Health and Community Medicine Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan1Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, TaiwanDepartment of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan2Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, TaiwanCardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan3School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanCardiovascular Center, Taichung Veterans General Hospital, Taichung, TaiwanInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, TaiwanDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, TaiwanDepartment of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan3School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan4Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan4Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, TaiwanBackgroundCYP2C19 loss-of-function (LOF) alleles reduce the effectiveness of clopidogrel and are associated with high rates of clinical events in patients undergoing percutaneous coronary intervention (PCI) and stenting in Northeast Asians. However, the prevalence and influence of CYP2C19 LOF alleles in Southeast Asians remain unclear.ObjectivesThis study aims to retrospectively investigate the prevalence of CYP2C19 LOF alleles and clinical outcomes in East Asian patients taking clopidogrel and undergoing PCI.MethodsBetween June 2019 and June 2020, volunteer participants in a single medical center were consecutively selected. The genetic data of CYP2C19 were derived from the Taiwan Precision Medicine Initiative (TPMI). Patients receiving clopidogrel while undergoing PCI with stenting were retrospectively analyzed.ResultsA total of 999 patients (62.4 ± 11.1 years old, 83.7% men) were enrolled; 39.3% without the CYP2C19 LOF allele (normal metabolizers + rapid metabolizers, NM + RM); 44.9% with one LOF allele (intermediate metabolizers, IM); 15.7% with two LOF alleles (poor metabolizers, PM). The incidence of stroke was higher in the PM subgroup compared to the NM + RM subgroup or IM subgroup in patients presenting with acute myocardial infarction (AMI). The 1-year major adverse cardiac and cerebrovascular events (MACCE)-free survival rates in all participants were similar among the three groups. However, in the AMI group, the 1-year MACCE-free survival rates were significantly lower in the PM subgroup compared to the NM + RM subgroup or IM subgroup.ConclusionIn East Asians presenting with AMI, CYP2C19 PM was associated with deleterious cardiovascular outcomes and stroke. Our results reinforce the crucial role of preemptive CYP2C19 genotyping in East Asian AMI patients receiving clopidogrel treatment.https://www.frontiersin.org/articles/10.3389/fcvm.2022.994184/fullclopidogrelcoronary artery diseaseCYP2C19dual antiplatelet therapyP2Y12 inhibitors |
| spellingShingle | Yu-Wei Chen Yu-Wei Chen Yu-Wei Chen Yi-Ju Liao Wei-Chun Chang Wei-Chun Chang Tzu-Hung Hsiao Tzu-Hung Hsiao Tzu-Hung Hsiao Ching-Heng Lin Ching-Heng Lin Ching-Heng Lin Ching-Heng Lin Chiann-Yi Hsu Chiann-Yi Hsu Tsun-Jui Liu Tsun-Jui Liu Wen-Lieng Lee Wen-Lieng Lee Wen-Lieng Lee Yi-Ming Chen Yi-Ming Chen Yi-Ming Chen Yi-Ming Chen Yi-Ming Chen CYP2C19 loss-of-function alleles predicts clinical outcomes in East Asian patients with acute myocardial infarction undergoing percutaneous coronary intervention and stenting receiving clopidogrel Frontiers in Cardiovascular Medicine clopidogrel coronary artery disease CYP2C19 dual antiplatelet therapy P2Y12 inhibitors |
| title | CYP2C19 loss-of-function alleles predicts clinical outcomes in East Asian patients with acute myocardial infarction undergoing percutaneous coronary intervention and stenting receiving clopidogrel |
| title_full | CYP2C19 loss-of-function alleles predicts clinical outcomes in East Asian patients with acute myocardial infarction undergoing percutaneous coronary intervention and stenting receiving clopidogrel |
| title_fullStr | CYP2C19 loss-of-function alleles predicts clinical outcomes in East Asian patients with acute myocardial infarction undergoing percutaneous coronary intervention and stenting receiving clopidogrel |
| title_full_unstemmed | CYP2C19 loss-of-function alleles predicts clinical outcomes in East Asian patients with acute myocardial infarction undergoing percutaneous coronary intervention and stenting receiving clopidogrel |
| title_short | CYP2C19 loss-of-function alleles predicts clinical outcomes in East Asian patients with acute myocardial infarction undergoing percutaneous coronary intervention and stenting receiving clopidogrel |
| title_sort | cyp2c19 loss of function alleles predicts clinical outcomes in east asian patients with acute myocardial infarction undergoing percutaneous coronary intervention and stenting receiving clopidogrel |
| topic | clopidogrel coronary artery disease CYP2C19 dual antiplatelet therapy P2Y12 inhibitors |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.994184/full |
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