The impact of CYP2C19 and CYP4F2 variants and clinical factors on treatment outcomes during antiplatelet therapy

Pharmacogenomics. 2019 May;20(7):483-492. doi: 10.2217/pgs-2018-0178.

Abstract

Aim: The aim of this study was to determine the impact of genetic and nongenetic factors on treatment outcomes in patients receiving dual antiplatelet therapy after percutaneous coronary intervention and stent implantation. Materials & methods: Patients (n = 628) used clopidogrel or ticagrelor for at least 1 week before platelet aggregation test. Results: Multivariate binary regression analysis demonstrated that aspirin use and CYP4F2 T allele significantly increased odds for bleeding in clopidogrel users (OR: 2.488, 95% CI: 1.452-4.265; p = 0.001 and OR: 1.573, 95% CI: 1.066-2.320; respectively; p = 0.022). CYP4F2 T allele significantly increased odds for bleeding in ticagrelor users (OR: 8.270, 95% CI: 3.917-17.462; p < 0.001). Conclusion: Aspirin use and CYP4F2 T allele were significantly associated with bleeding during dual antiplatelet therapy.

Keywords: bleeding; clopidogrel; dyspnea; ticagrelor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alleles
  • Aspirin / administration & dosage
  • Aspirin / adverse effects*
  • Clopidogrel / administration & dosage
  • Clopidogrel / adverse effects
  • Cytochrome P450 Family 4 / genetics*
  • Female
  • Genotype
  • Hemorrhage / drug therapy
  • Hemorrhage / genetics*
  • Hemorrhage / pathology
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / adverse effects*
  • Platelet Aggregation / drug effects
  • Platelet Aggregation / genetics
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / adverse effects
  • Postoperative Complications / drug therapy
  • Postoperative Complications / genetics
  • Stents
  • Ticagrelor / administration & dosage
  • Ticagrelor / adverse effects

Substances

  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Cytochrome P450 Family 4
  • CYP4F2 protein, human
  • Ticagrelor
  • Aspirin