Effects of CYP2C19 LoF allele on major adverse cardiovascular events associated with clopidogrel in acute coronary syndrome patients undergoing percutaneous coronary intervention: Meta-analysis

Biswas, Mohitosh and Sukasem, Chonlaphat and Khatun Kali, Most Sumaiya and Ibrahim, Baharudin (2021) Effects of CYP2C19 LoF allele on major adverse cardiovascular events associated with clopidogrel in acute coronary syndrome patients undergoing percutaneous coronary intervention: Meta-analysis. Pharmacogenomics, 23 (3). pp. 207-220. ISSN 1462-2416, DOI https://doi.org/10.2217/pgs-2021-0098.

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Abstract

The aggregated risk of major adverse cardiovascular events (MACE) in acute coronary syndrome (ACS) patients inheriting CYP2C19 loss-of function (LoF) alleles who underwent percutaneous coronary intervention (PCI) and were treated with clopidogrel is controversial. In the current study, we searched the literature in different databases for eligible studies. The risk ratio (RR) was measured where pCYP2C19 LoF alleles who underwent PCI, treated with clopidogrel were correlated with a significantly escalated risk of MACE compared with noncarriers (RR: 1.53, 95% CI: 1.39-1.69, p<0.00001), driven by CV death (RR: 1.88, 95% CI: 1.18-3.01, p=0.008), MI (RR: 1.67, 95% CI: 1.21-2.31, p=0.002) and ST (RR: 1.90, 95% CI: 1.27-2.84, p=0.002). Patients with two CYP2C19 LoF alleles were correlated with significantly greater risk of MACE compared with noncarriers (RR: 3.91, 95% CI: 2.78-5.50, p<0.00001). Further analysis revealed that the risk of MACE was markedly significant in Asian patients (RR: 2.02, 95% CI: 1.67-2.44, p<0.00001) and was comparatively low significance in western patients (RR: 1.35, 95% CI: 1.20-1.52, p<0.00001). There was no significantly different bleeding events in patients with CYP2C19 LoF alleles compared with noncarriers (RR: 0.99, 95% CI: 0.85-1.15, p=0.87). The ACS patients inheriting CYP2C19 LoF alleles, who underwent PCI and were treated with clopidogrel were correlated with significantly increased risk of MACE compared with noncarriers.

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: Acute coronary syndrome;Clopidogrel;Major adverse cardiovascular events;Percutaneous coronary intervention
Subjects: R Medicine
R Medicine > RC Internal medicine
R Medicine > RM Therapeutics. Pharmacology
Divisions: Faculty of Pharmacy
Depositing User: Ms Zaharah Ramly
Date Deposited: 18 Oct 2022 06:48
Last Modified: 18 Oct 2022 06:48
URI: http://eprints.um.edu.my/id/eprint/35259

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