Genetic and clinical determinants of MACE and haemorrhage in antiplatelet therapy: insights from pharmacogenomic analysis
BackgroundVariability 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 CYP2C19, ABCB1, and PON1 in predicting adverse cardiovascular events and guiding personalised antiplatele...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1572389/full |
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| author | Yubo Wang Yubo Wang Shuangli Yuan Muyun Li Wenling Feng Wenling Feng Jing Li Jing Li Wenwen Chen Wenwen Chen Aliye Berdi Yulian Kou Yuan Yuan Yuan Yuan Jun Zhao Jun Zhao |
| author_facet | Yubo Wang Yubo Wang Shuangli Yuan Muyun Li Wenling Feng Wenling Feng Jing Li Jing Li Wenwen Chen Wenwen Chen Aliye Berdi Yulian Kou Yuan Yuan Yuan Yuan Jun Zhao Jun Zhao |
| author_sort | Yubo Wang |
| collection | DOAJ |
| description | BackgroundVariability 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 CYP2C19, ABCB1, and PON1 in predicting adverse cardiovascular events and guiding personalised antiplatelet therapy.MethodsA retrospective cohort study designed to compare the effectiveness and safety of the risk levels from CYP2C19 (*2, *3, *17), ABCB1 C3435T, and PON1 Q192R 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.ResultsThe results of this study indicate that patients in Group A, who received treatment consistent with multigene testing (CYP2C19, ABCB1, and PON1), 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, P = 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, P = 0.271) after adjustment.ConclusionMultigene-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. |
| format | Article |
| id | doaj-art-b388a9cd68fd463d8e8d2cc95f254ece |
| institution | OA Journals |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-b388a9cd68fd463d8e8d2cc95f254ece2025-08-20T01:51:16ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-05-011210.3389/fcvm.2025.15723891572389Genetic and clinical determinants of MACE and haemorrhage in antiplatelet therapy: insights from pharmacogenomic analysisYubo Wang0Yubo Wang1Shuangli Yuan2Muyun Li3Wenling Feng4Wenling Feng5Jing Li6Jing Li7Wenwen Chen8Wenwen Chen9Aliye Berdi10Yulian Kou11Yuan Yuan12Yuan Yuan13Jun Zhao14Jun Zhao15Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, ChinaXinjiang Key Laboratory of Clinical Drug Research, Urumqi, Xinjiang Uygur Autonomous Region, ChinaDepartment of Pharmacy, The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, ChinaPharmacy School, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, ChinaDepartment of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, ChinaXinjiang Key Laboratory of Clinical Drug Research, Urumqi, Xinjiang Uygur Autonomous Region, ChinaDepartment of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, ChinaXinjiang Key Laboratory of Clinical Drug Research, Urumqi, Xinjiang Uygur Autonomous Region, ChinaDepartment of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, ChinaXinjiang Key Laboratory of Clinical Drug Research, Urumqi, Xinjiang Uygur Autonomous Region, ChinaPharmacy School, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, ChinaPharmacy School, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, ChinaDepartment of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, ChinaXinjiang Key Laboratory of Clinical Drug Research, Urumqi, Xinjiang Uygur Autonomous Region, ChinaDepartment of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, ChinaXinjiang Key Laboratory of Clinical Drug Research, Urumqi, Xinjiang Uygur Autonomous Region, ChinaBackgroundVariability 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 CYP2C19, ABCB1, and PON1 in predicting adverse cardiovascular events and guiding personalised antiplatelet therapy.MethodsA retrospective cohort study designed to compare the effectiveness and safety of the risk levels from CYP2C19 (*2, *3, *17), ABCB1 C3435T, and PON1 Q192R 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.ResultsThe results of this study indicate that patients in Group A, who received treatment consistent with multigene testing (CYP2C19, ABCB1, and PON1), 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, P = 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, P = 0.271) after adjustment.ConclusionMultigene-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.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1572389/fullantiplatelet therapyclopidogrelpharmacogenomicsmultigene testingpersonalized medicinecardiovascular events |
| spellingShingle | Yubo Wang Yubo Wang Shuangli Yuan Muyun Li Wenling Feng Wenling Feng Jing Li Jing Li Wenwen Chen Wenwen Chen Aliye Berdi Yulian Kou Yuan Yuan Yuan Yuan Jun Zhao Jun Zhao Genetic and clinical determinants of MACE and haemorrhage in antiplatelet therapy: insights from pharmacogenomic analysis Frontiers in Cardiovascular Medicine antiplatelet therapy clopidogrel pharmacogenomics multigene testing personalized medicine cardiovascular events |
| title | Genetic and clinical determinants of MACE and haemorrhage in antiplatelet therapy: insights from pharmacogenomic analysis |
| title_full | Genetic and clinical determinants of MACE and haemorrhage in antiplatelet therapy: insights from pharmacogenomic analysis |
| title_fullStr | Genetic and clinical determinants of MACE and haemorrhage in antiplatelet therapy: insights from pharmacogenomic analysis |
| title_full_unstemmed | Genetic and clinical determinants of MACE and haemorrhage in antiplatelet therapy: insights from pharmacogenomic analysis |
| title_short | Genetic and clinical determinants of MACE and haemorrhage in antiplatelet therapy: insights from pharmacogenomic analysis |
| title_sort | genetic and clinical determinants of mace and haemorrhage in antiplatelet therapy insights from pharmacogenomic analysis |
| topic | antiplatelet therapy clopidogrel pharmacogenomics multigene testing personalized medicine cardiovascular events |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1572389/full |
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