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Cardiology. 2011;119(1):15-20. doi: 10.1159/000329048. Epub 2011 Jul 16.

The value of combining CYP2C19*2 polymorphism with classic risk factors in prediction of clinical prognosis in acute coronary syndrome patients.

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  • 1Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.

Abstract

OBJECTIVES:

To assess the impact of different CYP2C19*2 polymorphisms on clinical outcomes and the effects of CYP2C19*2 polymorphism on predicting clinical outcomes in association with classic risk factors in patients with acute coronary syndromes (ACS).

METHODS:

Between July 2008 and September 2009, 497 consecutive patients with ACS who were admitted to the West China Hospital of Sichuan University were enrolled and underwent CYP2C19*2 determination. The clinical outcomes were the composite of cardiovascular death, nonfatal myocardial infarction and nonfatal stroke.

RESULTS:

Baseline characteristics were balanced between noncarrier, heterozygous and homozygous groups of the CYP2C19*2 variant. The clinical endpoint occurred more frequently in the homozygous group (HR 4.86, CI 1.62-14.56, p = 0.005). After multivariable analysis, the CYP2C19*2 genetic variant was an independent predictor of cardiovascular events (HR 5.96, CI 1.77-20.03, p = 0.0039) as well as GRACE score and Killip class. The combination of CYP2C19*2 with GRACE score and Killip class increases the potential to predict adverse outcomes.

CONCLUSIONS:

Homozygosity (A/A) for CYP2C19*2 mutant is an independent determinant of prognosis in patients with ACS. The combination of CYP2C19*2 polymorphism with classic risk factors may be a useful tool to predict the risk of cardiovascular events.

Copyright © 2011 S. Karger AG, Basel.

PMID:
21778720
[PubMed - indexed for MEDLINE]
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