Pharmacogenetic testing for CYP2C19 gene polymorphism for optimization of using antiplatelet therapy in patients with ischemic heart disease

Karpenko, Olena

doi:10.15587/2519-4798.2016.76377

Cited by 1 publication

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“…With the help of the Aggredyne-test, it was found that a different degree of antiplatelet resistance was found in 64.8 % of patients, which is consistent with the current literature, as noted in the study "Special antiplatelet therapy can overcome resistance to aspirin and clopidogrel" with a total of 504 patients among which 30.8 % was found with a low response to clopidogrel and 19.4 % with a low response rate to aspirin [10]. Also, in the study of the effect of the CYP2C19 gene on antithrombotic resistance in patients with coronary heart disease, it was found that 53.8 % of patients had an accelerated ADP-induced aggregation [21].…”

Section: Discussionmentioning

confidence: 99%

Genetic Features of Resistance to Antithrombocytic Drugs in Patients With Ischemic Heart Disease After Conducted Percutaneous Coronary Intervention

Liakhotska

2017

EUREKA: Health Sciences

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The aim of the study: To study and evaluate platelets aggregation activity as primary phase of haemostasis and anti-platelet therapy in IHD patients after PCI, depending on the polymorphism of the gene ITGA 2 - C 807T. Materials and methods: 54 patients who were on a treatment at the clinical hospital "Feofaniya" (Kyiv) and at the Kyiv Clinical Hospital on railway transport №2 were examined: 20 women and 34 men (mean age - 67.8 ± 7.46 years). The study involved patients with stable forms of coronary artery disease (stable angina pectoris II-III) and acute coronary syndrome, with a history of percutaneous coronary intervention (PCI). All patients received antiplatelet therapy: acetylsalicylic acid (3.7%), clopidogrel (9.3%) or a combination of them (87%). Functional activity of the platelets was studied on a Biola Aggregation Analyzer laser agrometer. The response to antiplatelet therapy was confirmed by the Aggredyne test. The polymorphism of the C807T of the ITGA2 gene was determined by polymerase chain reaction (PCR). Based on the results of the aggregation ability, antiplatelet therapy sensitivity, the patients were divided into two groups: group I - individuals with varying degrees of insensitivity to antiplatelet drugs (35 patients), group II - susceptible to treatment (19 patients). In each group was analyzed the polymorphism of the gene ITGA2 and features of the functional activity of the platelets, depending on the genotype. Results: In 50% of patients receiving ASA there was a different degree of non-sensitivity, with respect to thienopyridines - this figure was 20%. Among patients who received dual antiplatelet therapy did not match at least one of the drugs - 83.3%. Among the "non responders" 78.9% had a mutated T-allele, and a homozygous variant for the T allele was recorded in 53.15% of patients, while "respondents" - 15.8%. Most in the group of "respondents" was the group of the native genotype - C / C. The most pronounced tendency to influence the genotype on spontaneous aggregation was observed in relation to the T-allele, in particular in the homozygote (genotype T / T). The significant difference between the groups was obtained from the platelet response to ADP. Thus, the reaction of carriers in the T-allele, as homo- and heterozygotes, was significantly different. Conclusions: In 64.8% of patients with coronary heart disease after PCI was observed a decrease in antiplatelet sensitivity, which has a clear link with the polymorphism of the gene ITGA 2. The presence of the T-allele in the genotype of patients with IHD is associated with a less adequate platelet response in patients receiving dual antiplatelet therapy for ASA and thienopyridines on ADP, which may have an effect on the sensitivity to thienopyridines.

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Section: Discussionmentioning

confidence: 99%

Genetic Features of Resistance to Antithrombocytic Drugs in Patients With Ischemic Heart Disease After Conducted Percutaneous Coronary Intervention

Liakhotska

2017

EUREKA: Health Sciences

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show abstract

Pharmacogenetic testing for CYP2C19 gene polymorphism for optimization of using antiplatelet therapy in patients with ischemic heart disease

Cited by 1 publication

References 4 publications

Genetic Features of Resistance to Antithrombocytic Drugs in Patients With Ischemic Heart Disease After Conducted Percutaneous Coronary Intervention

Genetic Features of Resistance to Antithrombocytic Drugs in Patients With Ischemic Heart Disease After Conducted Percutaneous Coronary Intervention

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