Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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Correlation Between the CYP2C19 Phenotype Status and the Results of Three Different Platelet Function Tests in Cardiovascular Disease Patients Receiving Antiplatelet Therapy: An Emphasis on Newly Introduced Platelet Function Analyzer-200 P2Y Test

  • Li, Shuhua (Department of Laboratory Medicine, Dong-A University College of Medicine) ;
  • Choi, Jae-Lim (Department of Laboratory Medicine, Dong-A University College of Medicine) ;
  • Guo, Long Zhe (Department of Cardiology, Dong-A University College of Medicine) ;
  • Goh, Ri-Young (Department of Laboratory Medicine, Dong-A University College of Medicine) ;
  • Kim, Bo-Ram (Department of Laboratory Medicine, Dong-A University College of Medicine) ;
  • Woo, Kwang-Sook (Department of Laboratory Medicine, Dong-A University College of Medicine) ;
  • Kim, Moo-Hyun (Department of Cardiology, Dong-A University College of Medicine) ;
  • Han, Jin-Yeong (Department of Laboratory Medicine, Dong-A University College of Medicine)
  • Received : 2015.04.29
  • Accepted : 2015.10.06
  • Published : 2016.01.01
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Abstract

Background: An association has been reported between CYP2C19 polymorphism and the altered antiplatelet activity of clopidogrel. We investigated this association using the newly introduced platelet function analyzer (PFA)-200 (INNOVANCE PFA-200 System; Siemens Healthcare, Germany) P2Y test. Methods: Polymorphisms of $CYP2C19^*2$, $^*3$, $^*17$ and the degree of inhibition of platelet function were determined in 83 patients. Three different platelet function tests were used to evaluate the degree of platelet inhibition and to check the association with genotype. Results: The post-procedure PFA-200 values of extensive metabolizers (EM) patients ($285.3{\pm}38.8$) were higher than those of intermediate metabolizers (IM) and poor metabolizers (PM) patients ($227.7{\pm}98.3$ and $133.7{\pm}99.2$, respectively; P=0.024). Light transmittance aggregometry (LTA) and the VerifyNow system showed that the post-procedure values for EM patients were lower than those of IM and PM patients (LTA: $24.4{\pm}15.7$, $34.1{\pm}17.6$, and $42.2{\pm}16.9$, respectively, P<0.001; VerifyNow: $133.2{\pm}60.5$, $171.5{\pm}42.6$, and $218.7{\pm}59.3$, respectively, P<0.001). The high residual platelet reactivity (HPR) rates were significantly different among the EM, IM, and PM groups using PFA-200 (PM:IM:EM=82.4:40.6:11.8, P<0.001). Conclusions: Approximately, 59.0% of Korean patients with cardiovascular disease receiving clopidogrel had CYP2C19 loss-of-function genotypes classified as IM or PM, and the frequency was similar to the data from Asian people. The PFA-200, LTA, and VerifyNow platelet function tests revealed evidence of a significant association between the efficacy of clopidogrel and CYP2C19 genotypes.

Keywords

Acknowledgement

Supported by : Dong-A University

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