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CYP2C19*2 and prognosis after an acute coronary syndrome: Insights from a Portuguese center

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dc.contributor.authorTeixeira, R
dc.contributor.authorMonteiro, P
dc.contributor.authorMarques, G
dc.contributor.authorPego, J
dc.contributor.authorLourenço, M
dc.contributor.authorTavares, C
dc.contributor.authorReboredo, A
dc.contributor.authorMonteiro, S
dc.contributor.authorGonçalves, F
dc.contributor.authorFerreira, MJ
dc.contributor.authorFreitas, M
dc.contributor.authorRibeiro, G
dc.contributor.authorProvidência, LA
dc.date.accessioned2012-03-14T18:15:12Z
dc.date.available2012-03-14T18:15:12Z
dc.date.issued2012
dc.description.abstractBACKGROUND: Clopidogrel requires oxidation dependent on the cytochrome P450 enzyme 2C19 (CYP2C19) to form its active metabolite. The importance of loss-of-function alleles (particularly CYP2C19*2, 681G>A) in poor platelet response to clopidogrel is well recognized. OBJECTIVE: To investigate the prevalence and prognostic impact of the CYP2C19*2 allele in a local acute coronary syndrome (ACS) population. METHODS: We performed a prospective, longitudinal study of 95 patients admitted for an ACS between March and October 2009 to a single coronary care unit. Patients aged under 75 who survived hospital stay and for whom clopidogrel was prescribed were included. At discharge, CYP2C19 was genotyped using a commercially available kit. Patients were divided into two groups: Group A (non-carriers, normal metabolizers, CYP2C19*1/*1), n=69; and Group B (carriers, slow metabolizers, CYP2C19*2/*1 or *2/*2), n=26. The primary endpoint was a combined outcome of cardiovascular death, non-fatal myocardial infarction or re-admission for unstable angina; median follow-up was 136.0 (79.0-188.0) days. RESULTS: The median age of the population was 62.0 (51.0-68.0) years, and 83.2% were male. The CYP2C19*2 (A) allele had a frequency of 14.2%. There were no differences between the groups with respect to demographic data or history of cardiovascular disease. Coronary anatomy, left ventricular ejection fraction and renal function were also similar. The groups were also homogenous with respect to GRACE risk score (118.0 (95.0-136.5) vs. 115.0 (96.0-133.0), p=0.68), medical treatment and percutaneous revascularization during hospital stay. Event-free survival was higher for Group A (94.0% vs. 75.0%, log-rank p=0.010). Three readmissions for MI were documented, all in the slow metabolizers group. CONCLUSION: In our ACS population, the CYP2C19*2 allele was a medium-term prognostic marker.por
dc.identifier.citationRev Port Cardiol. 2012 Feb 27. [Epub ahead of print]por
dc.identifier.urihttp://hdl.handle.net/10400.4/1344
dc.language.isoengpor
dc.peerreviewedyespor
dc.subjectSíndrome Coronária Agudapor
dc.subjectPrognósticopor
dc.titleCYP2C19*2 and prognosis after an acute coronary syndrome: Insights from a Portuguese centerpor
dc.title.alternativeImportância prognóstica do alelo CYP2C19*2 após uma síndrome coronária aguda: dados de um centro nacionalpor
dc.typejournal article
dspace.entity.typePublication
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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