Association betweenCYP2C19Polymorphisms and Outcomes in Cerebral Endovascular Therapy

• DOI: 10.3174/ajnr.a4481
• Publication Date: 2015-09-04T01:54:10Z
• Authors: M. Lin; M. Todaro; J. Chan; L. Churilov; W.S. Zhu; S. Ramdave; P.J. Mitchell; R.J. Dowling; P. Kwan; B. Yan
• Keywords: Interquartile range

<h3>BACKGROUND AND PURPOSE:</h3> Differing responses to clopidogrel following endovascular treatment of cerebrovascular diseases may increase the risk vascular complications. <i>CYP2C19</i> gene polymorphisms influence activity. We aimed study clinical impact in patients undergoing treatment. <h3>MATERIALS METHODS:</h3> This was a prospective, longitudinal, observational study. Information on demographics and status collected as baseline. Clopidogrel response tested by VerifyNow P2Y12 assay. genotyping undertaken polymerase chain reaction–restriction fragment length polymorphism. Three-month follow-up data included complications, mortality, modified Rankin Scale score. Associations were investigated among genotypes, responsiveness, outcomes. <h3>RESULTS:</h3> One hundred eight participants included. Median age 56 years (interquartile range, 48.8–65.0 years), 35 (32.4%) male. Forty-four classified into group 1 (homozygous <i>CYP2C19</i>*<i>1</i>/*<i>1</i>); 31, 2 (25 with <i>CYP2C19</i>*<i>1</i>/*<i>2</i>, two <i>CYP2C19</i>*<i>1</i>/*<i>3</i>, three <i>CYP2C19</i>*<i>3</i>/*<i>3</i>, one <i>CYP2C19</i>*<i>2</i>/*<i>3</i>); 28, 3 (24 <i>CYP2C19</i>*<i>1</i>/*<i>17</i>, four <i>CYP2C19</i>*<i>17</i>/*<i>17</i>); 5, 4 (<i>CYP2C19</i>*<i>2</i>/*<i>17</i>). A significantly higher proportion experienced ischemic events (9 32.1%) compared (5 44, 11.4%; <i>P</i> = .04; odds ratio, 3.7; 95% confidence interval, 1.1–12.6). There no significant difference genotype groups. <h3>CONCLUSIONS:</h3> Individuals <i>CYP2C19</i>*<i>17</i> have increased treatment, independent responsiveness. Larger studies are required confirm outcomes understand mechanisms for events.