Abstract 2127: Protective Effect of the CYP Polymorphism With Increased Activation of Clopidogrel on Cardiovascular Events
Background: The prodrug Clopidogrel requires activation by cytochrome P-450 (CYP) enzymes for its antiplatelet effect. The genes encoding CYP enzymes are polymorphic, leading to reduced or increased function, depending on the respective genotype. Reduced function alleles have been associated with an increase in cardiovascular events.
Methods: We tested the association between the CYP 2C19 *17 (C/T) T-allele leading to increased function and further cardiovascular events in a high risk population of 925 patients with acute myocardial infarction (MI). Genotyping was performed with the PCR based TaqMan assay.
Results: Carriers of the protective T-allele had a 18% relative reduction in the MACE composite end point of death from cardiovascular causes, MI, definite stent thrombosis, or target vessel revascularization(TLR) (33.6% vs. 40.9%, p=0.047), and a 36% relative decrease in the incidence of TLR (14.1% vs. 22.2%, p=0.0026), compared with noncarriers, respectively.
Conclusions: Based on the genetic analysis in a high risk population of acute MI patients with interventional treatment and long-term clopidogrel, our study found for the first time a protective effect for carriers of an increased-function CYP2C19 *17 T-allele with significantly lower rates of MACE and TLR.