抄録
Background
The aim of this study was to assess the impact of CYP2C19*17 on low platelet reactivity (PRU<85 for VerifyNow assay) in clopidogrel-treated patients with acute coronary syndrome (ACS) and percutaneous coronary intervention (PCI).
Material and methods
A total of 81 (64 males and 17 females) patients with ACS and PCI participated in the study. The mean age of patients enrolled was 63.9±10.9 years. We measured platelet reactivity using VerifyNow P2Y12 assay. Genomic DNA was extracted from venous blood. CYP2C19*17 alleles was determined by real-time polymerase chain reaction (Real-Time PCR). Fisher´s exact test was used to assess CYP2C19*17 allele frequency between patient with normal platelets reactivity (PRU>85) and low platelets reactivity (PRU<85). A P-value < 0.05 was considered statistically significant.
Results
From the 81 patients¸ included in research and genotyping by CYP2C19*17¸ 57(70%) were wild type homozygous (CC), 23 (28%) were heterozygotes (CT) and 1 (2%) was homozygous for the T-allelic variant (TT). C-allele frequency was 84.6% and incidence of T-allele was 15.4%. Genotype frequencies didn´t deviate significantly from Hardy-Weinberg equilibrium (p=0.42¸ x2=0.06). There were statistically significant differences in CYP2C19*17 allele frequency between patients with low platelet reactivity (LPR) (PRU<85) and in patients with a normal platelet reactivity (PRU>85): OR, 11.2; 95% CI, 1.18 to 106.32; p=0.0253).
Conclusion
Carriers of CYP2C19*17 allelic variant have the higher risk of developing LPR and risk of bleeding events¸ respectively. Futher research with large data is needed to prove the result of this study.
