Impact of CYP2C19 Metabolizer Status on Patients With ACS Treated With Prasugrel Versus Clopidogrel

• Published in: Journal of the American College of Cardiology Vol. 67; no. 8; pp. 936 - 947
• Main Authors: Doll, Jacob A., Neely, Megan L., Roe, Matthew T., Armstrong, Paul W., White, Harvey D., Prabhakaran, Dorairaj, Winters, Kenneth J., Duvvuru, Suman, Sundseth, Scott S., Jakubowski, Joseph A., Gurbel, Paul A., Bhatt, Deepak L., Ohman, E. Magnus, Fox, Keith A.A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2016; Elsevier Limited
• Subjects: acute coronary syndrome; Acute Coronary Syndrome - blood; Acute Coronary Syndrome - drug therapy; Acute Coronary Syndrome - genetics; Acute coronary syndromes; Aged; Alleles; Angina pectoris; Blood platelets; Cardiology; Cardiovascular; Cardiovascular disease; Clinical outcomes; Confidence intervals; Coronary vessels; Cytochrome P-450 CYP2C19 - genetics; Cytochrome P-450 CYP2C19 - metabolism; Deoxyribonucleic acid; DNA; DNA - genetics; Dose-Response Relationship, Drug; Double-Blind Method; Drug dosages; dual antiplatelet therapy; Enzymes; Female; Follow-Up Studies; Genetics; Genotype; Genotype & phenotype; Heart attacks; Humans; Male; Metabolism; Metabolites; Middle Aged; Platelet Aggregation Inhibitors - administration & dosage; Platelet Function Tests; platelets; Polymorphism, Genetic; Prasugrel Hydrochloride - administration & dosage; Purinergic P2Y Receptor Antagonists - administration & dosage; Retrospective Studies; Stroke; Ticlopidine - administration & dosage; Ticlopidine - analogs & derivatives; Treatment Outcome; United States > US; California; NSTEMI; FDA; CI; EM; HR; UA; platelets; dual antiplatelet therapy; ACS; PRU; acute coronary syndrome; genetics; PCI; CYP; RM; MI; myocardial infarction; P2Y 12 reaction unit; percutaneous coronary intervention; extensive metabolizer(s); non–ST-segment elevation myocardial infarction; U.S. Food and Drug Administration; cytochrome P450; reduced metabolizer(s); hazard ratio; confidence interval; unstable angina

Certain alleles of the CYP2C19 gene are associated with higher platelet reactivity and increased ischemic events among patients treated with clopidogrel. However, the relationship of CYP2C19 genotype and outcomes in medically managed patients with acute coronary syndromes (ACS) is not known. This st...