Association of polymorphisms of platelet receptors GPIa (807C>T), GPVI (13254T>C), and P2Y12 (34C>T and H1/H2 haplotype) with increased risk of periprocedural bleeding in patients undergoing coronary angiography/percutaneous coronary intervention

Abstract

IntroductionPeriprocedural bleeding related to coronary angiography (CAG) or percutaneous coronary intervention (PCI) is associated with worse prognosis. Determining genetic variations associated with increased bleeding risk may help to identify high-risk patients.AimTo analyse the association between single nucleotide polymorphisms (SNPs) of crucial haemostatic platelet receptors (GPIa, GPVI, P2Y12) and the risk of periprocedural bleeding complications related to CAG/PCI.Material and methodsThe population consisted of 73 patients with ischaemic heart disease who developed bleeding complications within 30 days after CAG/PCI and 331 patients without bleeding. The frequency of SNPs of GPIa 807C/T, GPVI 13254T/C, P2Y12 32C/T, and P2Y12 H1/H2 haplotype was analysed using polymerase chain reaction (PCR) hybridization methods.ResultsThe prevalence of variant alleles GPIa 807T, GPVI 13254C, P2Y12 34T, and P2Y12 H2 haplotype in the total study population was 56.7%, 20.3%, 56.2%, and 24.3%, respectively. The presence of variant alleles was not related to increased risk of periprocedural bleeding: GPIa 807C/T (OR = 1.29, 95% CI: 0.75–2.24, p = 0.334), GPVI 12354T/C (OR = 0.82, 95% CI: 0.40–1.64, p = 0.551), P2Y12 34C/T (OR = 0.71, 95% CI: 0.42–1.22, p = 0.189), P2Y12 H1/H2 haplotype (OR = 0.69, 95% CI: 0.35–1.36, p = 0.258). The frequency of the homozygous form of P2Y12 H2 haplotype was higher in the group of patients who developed bleeding (OR = 2.79, 95% CI: 0.51–13.77, p = 0.161).ConclusionsNo significant association of the SNPs of GPIa 807C/T, GPVI 13254T/C, P2Y12 32C/T, and P2Y12 H1/H2 haplotype with increased risk of periprocedural bleeding was found in patients with ischaemic heart disease undergoing CAG/PCI.

P2Y12 Polymorphisms and the Risk of Adverse Clinical Events in Patients Treated with Clopidogrel: A Meta-Analysis

“…Sionova M et al investigated the association of P2Y12 polymorphisms (C34T and T744C) with increased risk of peri-procedural bleeding in patients undergoing coronary angiography/PCI. No significant association of the SNPs of P2Y12 C32T and T744C with an increased risk of peri-procedural bleeding was found in their patients [40]. Since the study had a short-term follow-up (30 days), it was excluded from the meta-analysis.…”

A New Preprocedural Score to Predict Bleeding Complications of Endovascular Interventions for Peripheral Artery Disease

“…A prospective, single-center study was designed to investigate periprocedural bleeding complications occurring within the first 30 days 15,16 following an endovascular intervention for chronic PAD. Bleeding events in this analysis referred to retroperitoneal hemorrhage, pseudoaneurysm, vessel perforation, access site hematoma >5 cm or requiring surgical treatment, intracranial hemorrhage, or gastrointestinal bleeding; small (<5 cm), soft hematomas at the access site were not included.…”

Genetic testing in antiplatelet therapy – not effective for perioperative bleeding

“…Sianova et al [ 1 ] decided to perform a genetic analysis of single nucleotide polymorphisms (SNPs) of crucial hemostatic platelet receptors (GPIa, GPVI, P2Y12) and correlate their presence with the risk of periprocedural bleeding complications related to coronary angiography or percutaneous coronary intervention (PCI). From a presumably large database of several centers, they selected 73 patients who developed some sort of bleeding events during 30 days after the procedure, unfortunately excluding patients with the most severe types of bleeding (intracranial or fatal bleeding) because “it was impossible to obtain an informed consent for genetic testing from those critically ill patients”.…”