The Impact of CYP2C19 and CYP4F2 Variants and Clinical Factors on Treatment Outcomes During Antiplatelet Therapy

Abstract

Aim: The aim of this study was to determine the impact of genetic and nongenetic factors on treatment outcomes in patients receiving dual antiplatelet therapy after percutaneous coronary intervention and stent implantation. Materials & methods: Patients (n = 628) used clopidogrel or ticagrelor for at least 1 week before platelet aggregation test. Results: Multivariate binary regression analysis demonstrated that aspirin use and CYP4F2 T allele significantly increased odds for bleeding in clopidogrel users (OR: 2.488, 95% CI: 1.452–4.265; p = 0.001 and OR: 1.573, 95% CI: 1.066–2.320; respectively; p = 0.022). CYP4F2 T allele significantly increased odds for bleeding in ticagrelor users (OR: 8.270, 95% CI: 3.917–17.462; p < 0.001). Conclusion: Aspirin use and CYP4F2 T allele were significantly associated with bleeding during dual antiplatelet therapy.

Keywords::

• bleeding
• clopidogrel
• dyspnea
• ticagrelor

Financial & competing interests disclosure

These studies were funded by (grant number SEN-09/2015) the Research Council of Lithuania. The authors have no other relevant affiliations, and no financial involvement with any organisation or entity with a financial interest in, or financial conflict with, the subject matter or materials discussed in the manuscript.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research statement

All the procedures used have been reviewed in compliance with the ethical standards of the Regional Bioethics Committee of Kaunas, Lithuania (the permission number is BE-2-42) and the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects.

Written informed consent was obtained from all the participants.

Additional information

Funding

These studies were funded by (grant number SEN-09/2015) the Research Council of Lithuania. The authors have no other relevant affiliations, and no financial involvement with any organisation or entity with a financial interest in, or financial conflict with, the subject matter or materials discussed in the manuscript. No writing assistance was utilized in the production of this manuscript.