Clopidogrel Use and CYP2C19 Genotypes in Patients Undergoing Vascular Intervention Procedure: A Hospital-Based Study

• DOI: 10.2147/pgpm.s335860
• Publication Date: 2022-02-01T15:30:15Z
• Authors: Yi-Ju Liao; Tzu-Hung Hsiao; Ching-Heng Lin; Chun-Sheng Hsu; Yen-Lin Chang; Yu-Wei Chen; Chiann-Yi Hsu; Yi-Ming Chen; Ming-Fen Wu
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Pharmacogenomics and Personalized Medicine; Original Research; 3. Good health

Purpose: Clopidogrel is widely used in coronary artery, peripheral arterial, and cerebrovascular disease. We aimed to study the association of CYP2C19 phenotype with cardiovascular outcomes interventional procedures a hospital-based population. Patients Methods: This cross-sectional, retrospective enrolled patients prior exposure clopidogrel at Taichung Veterans General Hospital (TCVGH) using data extracted from Taiwan Precision Medicine Initiative (TPMI). Data on phenotype, drug-prescription profile, comorbidities, vascular intervention procedures, hospitalization due acute myocardial infarction (AMI) or stroke users were analyzed. Results: From 32,728 TCVGH-TPMI cohort, we selected 2687 users. A total 400 (14.9%) poor metabolizers (PMs), 1235 (46.0%) intermediate (IMs), 1052 (39.2%) extensive (EMs) identified. The predominant loss-of-function allele *2. In exposure, PM was unassociated AMI after adjusting for comorbidities carotid angiographies. Among 1554 who underwent intervention, 193 (12.4%) received two more types procedures. Compared non-PMs, had higher risk multiple interventions (OR: 3.13, 95% CI: 1.19– 8.22). Conclusion: this hospital-wide 8.2% users, which 14.9% PMs. result does not support universal genotyping all identify risks AMI. PMs are likely undergo than non-PMs. Prospective studies investigate genotype needed validate our results. Keywords: pharmacogenomics, clopidogrel, CYP2C19, precision medicine initiative, TPMI,