Open Access

Effects of different CYP2C19 genotypes on prognosis of patients complicated with atrial fibrillation taking clopidogrel after PCI

  • Authors:
    • Qifeng Zhang
    • Zhixiong Zhong
    • Bin Li
    • Zhengxian Liao
    • Pingsen Zhao
    • Zhuolian Ye
    • Xuebo He
    • Hao Wang
    • Wenhao Chen
    • Junping Huang
  • View Affiliations

  • Published online on: August 22, 2018     https://doi.org/10.3892/etm.2018.6650
  • Pages: 3492-3496
  • Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

The effects of different cytochrome P450 2C19 (CYP2C19) genotypes on the prognosis of clopidogrel resistance in patients complicated with atrial fibrillation taking clopidogrel after percutaneous coronary intervention (PCI) were investigated. Eighty patients who were complicated with atrial fibrillation and treated with clopidogrel antiplatelet therapy after PCI in Meizhou Hospital Affiliated to Zhongshan University from September 2015 to January 2017 were selected, and divided into two groups according to the CYP2C19 genotype: extensive metabolism (EM) group and poor metabolism (PM) group. The related risk factors of clopidogrel resistance were determined, and the platelet aggregation rate and clopidogrel resistance rate were compared between the two groups during treatment. Non-fatal myocardial infarction and serious life-threatening complications in the two groups were observed. The increased total cholesterol level and the history of smoking and drinking were the independent risk factors of atrial fibrillation after PCI. The platelet aggregation rates in the EM group at 1, 3 and 12 months after medication were significantly lower than those in the PM group in the same period (P<0.05). The clopidogrel resistance rates in EM group before medication and at 1, 3 and 12 months after medication were higher than those in PM group in the same period (P<0.05). The onset time of non-fatal myocardial infarction in EM group was earlier than that in PM group (P<0.05), the infarct area was larger than that in PM group (P<0.05), and the left ventricular ejection fraction (EF) after onset was lower than that in PM group (P<0.05). In conclusion, the increased total cholesterol level and the history of smoking and drinking are the independent risk factors of clopidogrel resistance in patients complicated with atrial fibrillation after PCI. The incidence rates of cardiac complications are increased significantly in patients with PM CYP2C19 genotype.

References

1 

Danielak D, Karaźniewicz-Łada M, Komosa A, Burchardt P, Lesiak M, Kruszyna Ł, Graczyk-Szuster A and Główka F: Influence of genetic co-factors on the population pharmacokinetic model for clopidogrel and its active thiol metabolite. Eur J Clin Pharmacol. 73:1623–1632. 2017. View Article : Google Scholar : PubMed/NCBI

2 

Guirgis M, Thompson P and Jansen S: Review of aspirin and clopidogrel resistance in peripheral arterial disease. J Vasc Surg. 66:1576–1586. 2017. View Article : Google Scholar : PubMed/NCBI

3 

Kagami T, Yamade M, Suzuki T, Uotani T, Hamaya Y, Iwaizumi M, Osawa S, Sugimoto K, Umemura K, Miyajima H, et al: Comparative study of effects of vonoprazan and esomeprazole on anti-platelet function of clopidogrel or prasugrel in relation to CYP2C19 genotype. Clin Pharmacol Ther. Sep 5–2017.(Epub ahead of print). PubMed/NCBI

4 

Larson EA and Miller NJ: Point-Counterpoint: CYP2C19 Genotyping for Clopidogrel. S D Med. 70:13–15. 2017.PubMed/NCBI

5 

Mirabbasi SA, Khalighi K, Wu Y, Walker S, Khalighi B, Fan W, Kodali A and Cheng G: CYP2C19 genetic variation and individualized clopidogrel prescription in a cardiology clinic. J Community Hosp Intern Med Perspect. 7:151–156. 2017. View Article : Google Scholar : PubMed/NCBI

6 

Amin AM, Sheau Chin L, Mohamed Noor DA, Mostafa H, Abdul Kader MASK, Kah Hay Y and Ibrahim B: The effect of CYP2C19 genetic polymorphism and non-genetic factors on clopidogrel platelets inhibition in East Asian coronary artery disease patients. Thromb Res. 158:22–24. 2017. View Article : Google Scholar : PubMed/NCBI

7 

Berinstein E and Levy A: Recent developments and future directions for the use of pharmacogenomics in cardiovascular disease treatments. Expert Opin Drug Metab Toxicol. 13:973–983. 2017. View Article : Google Scholar : PubMed/NCBI

8 

Chen S, Zhang Y, Wang L, Geng Y, Gu J, Hao Q, Wang H and Qi P: Effects of dual-dose clopidogrel, clopidogrel combined with tongxinluo capsule, and ticagrelor on patients with coronary heart disease and CYP2C19*2 gene mutation after percutaneous coronary interventions (PCI). Med Sci Monit. 23:3824–3830. 2017. View Article : Google Scholar : PubMed/NCBI

9 

Zhang J, Zhang J, Sun H, Ming T, Liu X, Cong Y, Li F and Li Z: Association between platelet function and recurrent ischemic vascular events after TIA and minor stroke. Int J Clin Pharmacol Ther. 55:789–797. 2017. View Article : Google Scholar : PubMed/NCBI

10 

Erathi HV, Durgaprasad R, Velam V, Sarma PV, Rodda M, Kapil C and Kanavath SN: Evaluation of On-Clopidogrel platelet reactivity overtime, SYNTAX SCORE, genetic polymorphisms and their relationship to one year clinical outcomes in STEMI patients undergoing PCI. Minerva Cardioangiol. 66:16–25. 2018.PubMed/NCBI

11 

Borse MS, Dong OM, Polasek MJ, Farley JF, Stouffer GA and Lee CR: CYP2C19-guided antiplatelet therapy: A cost-effectiveness analysis of 30-day and 1-year outcomes following percutaneous coronary intervention. Pharmacogenomics. 18:1155–1166. 2017. View Article : Google Scholar : PubMed/NCBI

12 

Tan SSN, Fong AYY, Mejin M, Gerunsin J, Kong KL, Chin FYY, Tiong LL, Lim MSH, Asri S, Khiew NZ, et al: Association of CYP2C19*2 polymorphism with clopidogrel response and 1-year major adverse cardiovascular events in a multiethnic population with drug-eluting stents. Pharmacogenomics. 18:1225–1239. 2017. View Article : Google Scholar : PubMed/NCBI

13 

Palacharla RC, Nirogi R, Uthukam V, Manoharan A, Ponnamaneni RK and Kalaikadhiban I: Quantitative in vitro phenotyping and prediction of drug interaction potential of CYP2B6 substrates as victims. Xenobiotica. 28:1–13. 2017.

14 

Peng L, Liu J, Qin L, Liu J, Xi S, Lu C and Yin T: Interaction between platelet-derived microRNAs and CYP2C19*2 genotype on clopidogrel antiplatelet responsiveness in patients with ACS. Thromb Res. 157:97–102. 2017. View Article : Google Scholar : PubMed/NCBI

15 

Cavallari LH: Personalizing antiplatelet prescribing using genetics for patients undergoing percutaneous coronary intervention. Expert Rev Cardiovasc Ther. 15:581–589. 2017. View Article : Google Scholar : PubMed/NCBI

16 

Rosafio F, Lelli N, Mimmi S, Vandelli L, Bigliardi G, Dell'Acqua ML, Picchetto L, Pentore R, Ferraro D, Trenti T, et al: Platelet function testing in patients with acute ischemic stroke: An observational study. J Stroke Cerebrovasc Dis. 26:1864–1873. 2017. View Article : Google Scholar : PubMed/NCBI

17 

Li J, Wang Y and Wang H: Distribution of CYP2C19 polymorphisms in Mongolian and Han nationals and the choice of specific antiplatelet drugs. Int J Clin Pharm. 39:791–797. 2017. View Article : Google Scholar : PubMed/NCBI

18 

Tatarunas V, Kupstyte N, Zaliunas R, Giedraitiene A and Lesauskaite V: The impact of clinical and genetic factors on ticagrelor and clopidogrel antiplatelet therapy. Pharmacogenomics. 18:969–979. 2017. View Article : Google Scholar : PubMed/NCBI

19 

Choi YJ, Kim N, Jang IJ, Cho JY, Nam RH, Park JH, Jo HJ, Yoon H, Shin CM, Park YS, et al: Pantoprazole does not reduce the antiplatelet effect of clopidogrel: A randomized controlled trial in Korea. Gut Liver. 11:504–511. 2017. View Article : Google Scholar : PubMed/NCBI

20 

Cavallari LH, Weitzel KW, Elsey AR, Liu X, Mosley SA, Smith DM, Staley BJ, Winterstein AG, Mathews CA, Franchi F, et al: Institutional profile: University of Florida Health Personalized Medicine Program. Pharmacogenomics. 18:421–426. 2017. View Article : Google Scholar : PubMed/NCBI

Related Articles

Journal Cover

October 2018
Volume 16 Issue 4

Print ISSN: 1792-0981
Online ISSN:1792-1015

Sign up for eToc alerts

Recommend to Library

Copy and paste a formatted citation
APA
Zhang, Q., Zhong, Z., Li, B., Liao, Z., Zhao, P., Ye, Z. ... Huang, J. (2018). Effects of different CYP2C19 genotypes on prognosis of patients complicated with atrial fibrillation taking clopidogrel after PCI. Experimental and Therapeutic Medicine, 16, 3492-3496. https://doi.org/10.3892/etm.2018.6650
MLA
Zhang, Q., Zhong, Z., Li, B., Liao, Z., Zhao, P., Ye, Z., He, X., Wang, H., Chen, W., Huang, J."Effects of different CYP2C19 genotypes on prognosis of patients complicated with atrial fibrillation taking clopidogrel after PCI". Experimental and Therapeutic Medicine 16.4 (2018): 3492-3496.
Chicago
Zhang, Q., Zhong, Z., Li, B., Liao, Z., Zhao, P., Ye, Z., He, X., Wang, H., Chen, W., Huang, J."Effects of different CYP2C19 genotypes on prognosis of patients complicated with atrial fibrillation taking clopidogrel after PCI". Experimental and Therapeutic Medicine 16, no. 4 (2018): 3492-3496. https://doi.org/10.3892/etm.2018.6650