Coexisting Polymorphisms of P2Y12 and CYP2C19 Genes as a Risk Factor for Persistent Platelet Activation With Clopidogrel

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概要

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• Background Coexisting polymorphisms of the genes affecting clopiogrel resistance may influence platelet activation. Methods and Results In 105 patients with acute coronary syndrome (ACS) treated with percutaneous coronary intervention, platelet function was measured and registered as closure time in the test with collagen and adenosine diphosphate (CADP-CT). Patients were followed for 12 months for death or recurrent myocardial infarction (MI). Genotyping revealed 7 carriers of both the C allele of P2Y12 and A allele of CYP2C19 (group 1), 14 carriers of the T allele of P2Y12 and A allele of CYP2C19 (group 2), 17 carriers of the C allele of P2Y12 and G allele of CYP2C19 (group 3) and 67 carriers of the T allele of P2Y12 and G allele of CYP2C19 (controls). The median CADP-CT value was significantly lower in group 1 than in group 2 or 3 (p<0.01) or controls (p<0.002), but did not differ between group 2 or 3 and controls. There were 2 cardiovascular deaths and 4 MI during follow-up, and the median CADP-CT value was lower in these patients (p=0.09). Conclusions Coexisting, rather then single, polymorphisms of different genes may be related to persistent platelet activation while on clopidogrel, which raises concern about harm in patients with ACS.

• 社団法人日本循環器学会の論文
• 2008-06-20

著者

• Grabowski Marcin

  First Department of Cardiology, Medical University of Warsaw

• Filipiak Krzysztof

  First Department of Cardiology, Medical University of Warsaw

• Opolski Grzegorz

  First Department of Cardiology, Medical University of Warsaw

• Grabowski Marcin

  First Department Of Cardiology Medical University Of Warsaw

• Malek Lukasz

  Coronary Disease Department and II Catheterization Laboratory, Institute of Cardiology

• Kisiel Bartlomiej

  Department of Internal Diseases and Rheumatology, Military Institute of the Health Services

• Spiewak Mateusz

  First Department of Cardiology, Medical University of Warsaw

• Kostrzewa Grazyna

  Department of Medical Genetics, Medical University of Warsaw

• Huczek Zenon

  First Department of Cardiology, Medical University of Warsaw

• Ploski Rafal

  Department of Medical Genetics, Medical University of Warsaw

• Filipiak Krzysztof

  First Department Of Cardiology Medical University Of Warsaw

• Spiewak Mateusz

  First Department Of Cardiology Medical University Of Warsaw

• Opolski Grzegorz

  First Department Of Cardiology Medical University Of Warsaw

• Huczek Zenon

  First Department Of Cardiology Medical University Of Warsaw

• Malek Lukasz

  Coronary Disease Department And Ii Catheterization Laboratory Institute Of Cardiology

• Ploski Rafal

  Department Of Medical Genetics Medical University Of Warsaw

• Kostrzewa Grazyna

  Department Of Medical Genetics Medical University Of Warsaw

• Kisiel Bartlomiej

  Department Of Internal Diseases And Rheumatology Military Institute Of The Health Services

• Ploski Rafal

  Department Of Medical Genetics Centre Of Biostructure Medical University Of Warsaw

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