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Effect of CYP3A4 22 and PPAR-α Genetic Variants on Platelet Reactivity in Patients Treated with Clopidogrel and Lipid-Lowering Drugs Undergoing Elective Percutaneous Coronary Intervention
This study aims to determine whether genetic variants that influence expression are associated with platelet reactivity in clopidogrel-treated patients undergoing elective percutaneous coronary intervention (PCI), and to evaluate the influence of statin/fibrate co-medication on these associations. A...
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Published in: | Genes 2020-09, Vol.11 (9) |
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Main Authors: | , , , , , , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Online Access: | Get full text |
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Summary: | This study aims to determine whether genetic variants that influence
expression are associated with platelet reactivity in clopidogrel-treated patients undergoing elective percutaneous coronary intervention (PCI), and to evaluate the influence of statin/fibrate co-medication on these associations. A study cohort was used containing 1124 consecutive elective PCI patients in whom
*22 and
(G209A and A208G) SNPs were genotyped and the VerifyNow P2Y
platelet reactivity test was performed. Minor allele frequencies were 0.4% for
*22/*22, 6.8% for
G209A AA, and 7.0% for
A208G GG.
*22 was not associated with platelet reactivity. The
genetic variants were significantly associated with platelet reactivity (G209A AA: -24.6 PRU [-44.7, -4.6],
= 0.016; A208G GG: -24.6 PRU [-44.3, -4.8],
= 0.015). Validation of these
results in two external cohorts, containing 716 and 882 patients, respectively, showed the same direction of effect, although not statistically significant. Subsequently, meta-analysis of all three cohorts showed statistical significance of both variants in statin/fibrate users (
= 0.04 for
G209A and
= 0.03 for A208G), with no difference in statin/fibrate non-users. In conclusion,
G209A and A208G were associated with lower platelet reactivity in patients undergoing elective PCI who were treated with clopidogrel and statin/fibrate co-medication. Further research is necessary to confirm these findings. |
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ISSN: | 2073-4425 |