Genetic and clinical determinants of MACE and haemorrhage in antiplatelet therapy: insights from pharmacogenomic analysis.

BACKGROUND

Variability in responses to clopidogrel and aspirin therapy for coronary artery disease has driven interest in pharmacogenomics. This study investigates the role of genetic variants in , , and in predicting adverse cardiovascular events and guiding personalised antiplatelet therapy.

METHODS

A retrospective cohort study designed to compare the effectiveness and safety of the risk levels from (), , and polymorphisms. The primary outcome was the incidence of haemorrhage and major adverse cardiovascular events (MACE). Kaplan Merir curves and Cox regression with IPTW adjustments were used for analysis.

RESULTS

The results of this study indicate that patients in Group A, who received treatment consistent with multigene testing (, , and ), experienced significantly lower major adverse cardiovascular events (MACE) compared to Group B. Multigene testing proved to be more accurate in predicting clopidogrel effectiveness and reducing adverse events without an increased risk of haemorrhage (HR 0.671, 95% CI: 0.526-0.855,  = 0.001). Patients in Group A showed no significant difference in haemorrhage risk compared to Group B, with an HR of 0.831 (95% CI: 0.598-1.155,  = 0.271) after adjustment.

CONCLUSION

Multigene-guided antiplatelet therapy is more effective in reducing adverse cardiovascular events. Further prospective studies are needed to validate these findings, incorporating genetic, environmental, and lifestyle factors for a comprehensive personalised medicine approach.