Academic Journal

Prognostic Impact of CYP2C19 Genotypes on Long‐Term Clinical Outcomes in Older Patients After Percutaneous Coronary Intervention

التفاصيل البيبلوغرافية
العنوان: Prognostic Impact of CYP2C19 Genotypes on Long‐Term Clinical Outcomes in Older Patients After Percutaneous Coronary Intervention
المؤلفون: Kim, Ju Hyeon, Lee, Seung‐Jun, Cha, Jung‐Joon, Park, Jae Hyoung, Hong, Soon Jun, Ahn, Tae Hoon, Kim, Byeong‐Keuk, Chang, Kiyuk, Park, Yongwhi, Song, Young Bin, Ahn, Sung Gyun, Suh, Jung‐Won, Lee, Sang Yeub, Cho, Jung Rae, Her, Ae‐Young, Jeong, Young‐Hoon, Kim, Hyo‐Soo, Kim, Moo Hyun, Shin, Eun‐Seok, Lim, Do‐Sun
المصدر: Journal of the American Heart Association ; volume 13, issue 10 ; ISSN 2047-9980
بيانات النشر: Ovid Technologies (Wolters Kluwer Health)
سنة النشر: 2024
الوصف: Background Carriers of CYP2C19 loss‐of‐function alleles have increased adverse events after percutaneous coronary intervention, but limited data are available for older patients. We aimed to evaluate the prognostic impact of CYP2C19 genotypes on clinical outcomes in older patients after percutaneous coronary intervention. Methods and Results The study included 1201 older patients (aged ≥75 years) who underwent percutaneous coronary intervention and received clopidogrel‐based dual antiplatelet therapy in South Korea. Patients were grouped on the basis of CYP2C19 genotypes. The primary outcome was 3‐year major adverse cardiac events, defined as a composite of cardiac death, myocardial infarction, and stent thrombosis. Older patients were grouped into 3 groups: normal metabolizer (36.6%), intermediate metabolizer (48.1%), and poor metabolizer (15.2%). The occurrence of the primary outcome was significantly different among the groups (3.1, 7.0, and 6.2% in the normal metabolizer, intermediate metabolizer, and poor metabolizer groups, respectively; P =0.02). The incidence rate of all‐cause death at 3 years was greater in the intermediate metabolizer and poor metabolizer groups (8.1% and 9.2%, respectively) compared with that in the normal metabolizer group (3.5%, P =0.03) without significant differences in major bleeding. In the multivariable analysis, the intermediate metabolizer and poor metabolizer groups were independent predictors of 3‐year clinical outcomes. Conclusions In older patients, the presence of any CYP2C19 loss‐of‐function allele was found to be predictive of a higher incidence of major adverse cardiac events within 3 years following percutaneous coronary intervention. This finding suggests a need for further investigation into an optimal antiplatelet strategy for older patients. Registration URL: https://clinicaltrials.gov . Identifier: NCT04734028.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1161/jaha.123.032248
DOI: 10.1161/JAHA.123.032248
الاتاحة: http://dx.doi.org/10.1161/jaha.123.032248
https://www.ahajournals.org/doi/full/10.1161/JAHA.123.032248
رقم الانضمام: edsbas.BDEE06EA
قاعدة البيانات: BASE