Division of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Korea University of College of Medicine, Seoul, South Korea.
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Sci Rep. 2021 Jan 19;11(1):1790. doi: 10.1038/s41598-020-80319-9.
Although dual antiplatelet therapy is essential for patients who undergo percutaneous coronary interventions, the risk of bleeding remains an unsolved problem, and there is limited information on the potential relationship between genetic variants and major bleeding. We analyzed the correlations between four major single nucleotide polymorphisms (CYP2C19, ABCB1, PON1, and P2Y12 G52T polymorphisms) and clinical outcomes in 4489 patients from a prospective multicenter registry. The primary endpoint was major bleeding, defined as a Bleeding Academic Research Consortium ≥ 3 bleeding event. The allelic frequencies of ABCB1, PON1, and both individual and combined CYP2C19 variants did not differ significantly between patient groups with and without major bleeding. However, the allelic frequency of the P2Y12 variant differed significantly between the two groups. Focusing on the P2Y12 G52T variant, patients in the TT group had a significantly higher rate of major bleeding (6.4%; adjusted hazard ratio [HR] 2.51; 95% confidence interval [CI] 1.08-5.84; p = 0.033) than patients in the other groups (GG [2.9%] or GT [1.9%]). Therefore, the TT variant of the P2Y12 G52T polymorphism may be an independent predictor of major bleeding.Trial registration: NCT02707445 ( https://clinicaltrials.gov/ct2/show/NCT02707445?term=02707445&draw=2&rank=1 ).
虽然双抗血小板治疗对接受经皮冠状动脉介入治疗的患者至关重要，但出血风险仍是一个未解决的问题，关于遗传变异与大出血之间潜在关系的信息有限。我们分析了 4489 例前瞻性多中心注册患者中 4 个主要单核苷酸多态性（CYP2C19、ABCB1、PON1 和 P2Y12 G52T 多态性）与临床结局之间的相关性。主要终点是大出血，定义为 Bleeding Academic Research Consortium ≥ 3 级出血事件。ABCB1、PON1 以及 CYP2C19 个体和联合变异的等位基因频率在大出血组和无大出血组之间没有显著差异。然而，P2Y12 变异的等位基因频率在两组之间存在显著差异。关注 P2Y12 G52T 变异，TT 组患者的大出血发生率明显更高（6.4%；调整后的危险比 [HR] 2.51；95%置信区间 [CI] 1.08-5.84；p=0.033），而其他两组（GG [2.9%]或 GT [1.9%]）患者则较低。因此，P2Y12 G52T 多态性的 TT 变异可能是大出血的独立预测因子。试验注册：NCT02707445（https://clinicaltrials.gov/ct2/show/NCT02707445?term=02707445&draw=2&rank=1）。
