Coronary artery diseaseEffect of Cytochrome P450 Polymorphisms on Platelet Reactivity After Treatment With Clopidogrel in Acute Coronary Syndrome
Section snippets
Methods
Consecutive patients admitted for non–ST elevation acute coronary syndromes to the Department of Cardiology of Timone Hospital (Marseille, France) from October 2004 to June 2006 were eligible for this prospective study. Non–ST elevation acute coronary syndromes were defined as clinical symptoms compatible with acute myocardial ischemia <12 hours before admission and ≥1 of the following: a new finding of ST-segment depression >0.05 mV, transient (<20 minutes) ST-segment elevation >0.1 mV, T-wave
Results
Six hundred three unrelated participants were included in our study. We assessed ADP-Ag, PRI VASP, and ADP-PS. PRI VASP and ADP-PS were evaluated in 455 and 600 participants, respectively. Table 2 lists the clinical characteristics of participants. All platelet parameters studied were correlated. The associations between ADP-Ag and PRI VASP (r = 0.62, p <0.0001) and between PRI VASP and ADP-PS (r = 0.52, p <0.0001) appeared stronger than the association between ADP-Ag and ADP-PS (r = 0.36, p
Discussion
The results of this study of a large population suggest that CYP2C19 gene polymorphisms participate in the variability of platelet response to clopidogrel in patients with non–ST elevation acute coronary syndromes treated with high loading doses of clopidogrel. First, we found that CYP2C19*2 allele carriers had higher platelet reactivity to ADP, whatever the studied platelet index. This result is consistent with previous findings in healthy subjects from Hulot et al.21 The association remained
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