Genotype-guided prescribing predictors in CYP2C19 intermediate metabolizers receiving percutaneous coronary intervention.

IF 1.9 4区医学 Q3 PHARMACOLOGY & PHARMACY Pharmacogenomics Pub Date : 2024-01-01 Epub Date: 2024-06-06 DOI:10.1080/14622416.2024.2355862

Joshua J Park, Gervacio Y Cabel, Kevin K Cheng, Jefferson Dang, Amer K Ardati, Jin Han, James C Lee

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Abstract

Background: Previous differences in guideline recommendation strength for CYP2C19 intermediate metabolizers may have limited genotype (PGx)-optimal post-percutaneous coronary intervention antiplatelet prescribing.Results: In this single-center retrospective observational cohort study of CYP2C19 intermediate metabolizers, patients prescribed PGx-optimal therapy were younger and less likely on anticoagulation (2 vs 12%; p = 0.006). More patients prescribed PGx-optimal therapy possessed commercial insurance (36 vs 7%; p < 0.001), which was a predictor for PGx-optimal selection (OR: 6.464; 95% CI: 2.386-17.516; p < 0.001).Conclusion: Anticoagulation use was significantly associated with clopidogrel use (OR: 0.138; 95% CI: 0.026-0.730; p = 0.020). No statistical difference in composite major adverse cardiovascular events (5 vs 14%; p = 0.173) or bleeding (8 vs 6%; Not significant) was observed between PGx-optimal and PGx-suboptimal therapy.

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接受经皮冠状动脉介入治疗的 CYP2C19 中间代谢者的基因型指导处方预测因子。

背景：以前针对 CYP2C19 中间代谢者的指南推荐强度的差异可能限制了基因型 (PGx) - 经皮冠状动脉介入治疗后抗血小板的最佳处方。结果：在这项针对CYP2C19中间代谢者的单中心回顾性观察队列研究中，处方PGx最佳疗法的患者更年轻，更少接受抗凝治疗（2 vs 12%; p = 0.006）。更多接受 PGx 最佳疗法的患者拥有商业保险（36 对 7%；P=0.006）：抗凝药物的使用与氯吡格雷的使用显著相关（OR：0.138；95% CI：0.026-0.730；P = 0.020）。在 PGx 最佳疗法和 PGx 次优疗法之间，复合主要心血管不良事件（5 vs 14%; p = 0.173）或出血（8 vs 6%; 无显著性差异）没有统计学差异。

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来源期刊

Pharmacogenomics 医学-药学

CiteScore

3.40

自引率

9.50%

发文量

审稿时长

4-8 weeks

期刊介绍： Pharmacogenomics (ISSN 1462-2416) is a peer-reviewed journal presenting reviews and reports by the researchers and decision-makers closely involved in this rapidly developing area. Key objectives are to provide the community with an essential resource for keeping abreast of the latest developments in all areas of this exciting field. Pharmacogenomics is the leading source of commentary and analysis, bringing you the highest quality expert analyses from corporate and academic opinion leaders in the field.