CYP2C19 Genotyping in Anticoagulated Patients After Percutaneous Coronary Intervention: Should It Be Routine?
CYP2C19 Genotyping in Anticoagulated Patients After Percutaneous Coronary Intervention: Should It Be Routine?
复制标题
DOI：
10.1161/circulationaha.121.057028
复制
发表时间：
2022-03-08
期刊：
影响因子：
37.8
通讯作者：
Fahed AC
中科院分区：
文献类型：
--
作者：
Maamari DJ;Jaffer FA;Khera AV;Fahed AC
CYP2C19 genotyping identifies alleles associated with the metabolizer status of clopidogrel and is routinely clinically available. A crucial result of this test is when poor metabolizers are identified because of the presence of 2 nonfunctional alleles in the gene (“clopidogrel nonresponders”). Decreased bioactivation of clopidogrel in those patients could lead to thrombotic complications following stent placement, particularly after stopping aspirin post-PCI, when clopidogrel serves as the sole antiplatelet agent. The CYP2C19 gene has around 35 (*) alleles cataloged, with CYP2C19* 1 considered as wild-type, and the 2 most common nonfunctional alleles are CYP2C19* 2 and CYP2C19* 3. 3 The frequency of carrying 2 nonfunctional alleles differs by ancestry and is estimated at 2% to 5% in individuals of European and African ancestry and up to 15% in individuals of Asian ancestry, where CYP2C19 testing may be of particularly higher value. 3 On the opposite end of the spectrum, CYP2C19* 17 is a common allele that associates with the ultrarapid metabolism of clopidogrel as well as higher bleeding rates. Thus, CYP2C19 genotyping can classify
