학술논문
Effect of Paraoxonase-1 Polymorphism on Clinical Outcomes in Patients Treated With Clopidogrel After an Acute Myocardial Infarction
Document Type
Academic Journal
Author
Source
Clinical Pharmacology & Therapeutics. Oct 01, 2011 90(4):561-567
Subject
Language
English
ISSN
0009-9236
Abstract
Paraoxonase-1 (PON1) Q192R polymorphism was recently suggested to determine perse clopidogrel response on major cardiovascular events (MACEs). We assessed the impact of PON1, CYP2C19, and ABCB1 polymorphisms on MACE in clopidogrel-treated acute myocardial infarction (AMI) patients (N = 2,210), including those undergoing percutaneous coronary intervention (PCI) (n = 1,538). PON1 polymorphism was not associated with increased risk of in-hospital death and MA CEs at 1 year (adjusted hazard ratio (HR) 1.03,95% confidence interval (CI) 0.66-1.61 and adjusted HR 0.77, 95% CI 0.42-1.41 for QQ versus RR in all and PCI patients, respectively). The presence of two CYP2C19 loss-of-function (LOF) alleles was associated with the risk of in-hospital death and MACEs at 1 year in the overall population (adjusted odds ratio (OR) 3.67, 95% C11.05-12.80 and adjusted HR 1.96, 95% C11.08-3.54) and in PCI patients (adjusted OR 6.87, 95% CI 2.52-18.72 and adjusted HR 3.06, 95% C11.47-6.41). Unlike CYP2C19 polymorphism, PON1 (Q192R) polymorphism is not a major pharmacogenetic contributor of clinical response to clopidogrel in AMI patients.