Journal of the American Heart Association, Volume 15, Issue 9 , May 5, 2026. BackgroundDual‐antiplatelet therapy is standard after percutaneous coronary intervention, but clopidogrel responsiveness varies withCYP2C19loss‐of‐function alleles.
Whether the genotype conveys different prognostic significance between sexes is uncertain.MethodsWe analyzed 4630 East‐Asian patients with acute coronary syndrome in the PTRG‐DES (Platelet Function– and Genotype‐Related Long‐Term Prognosis in Drug‐Eluting Stent–Treated Patients With Coronary Artery Disease) consortium with availableCYP2C19genotyping. Patients were classified as rapid/normal metabolizers versus intermediate/poor metabolizers.
The primary end point was cardiac death, myocardial infarction, or definite stent thrombosis within 5 years.ResultsAmong 4630 patients with acute coronary syndrome, 1708 (36.9%) were women. The prevalence of intermediate/poor metabolizer phenotypes was similar in women (61.8%) and men (62.5%).
After multivariable adjustment for clinical, laboratory, and procedural confounders, intermediate/poor metabolizer carriers had a significantly higher risk of the 5‐year primary outcome in men compared with rapid/normal metabolizer carriers (adjusted hazard ratio [HR], 3.27 [95% CI, 1.58–6.74];P=0.001). In contrast, no significant association was observed in women (adjusted HR, 1.21 [95% CI, 0.58–2.52];P= 0.615).
Journal of the American Heart Association published a clinical update in Cardiology on 28 Apr 2026.
The item focuses on Sex Differences in Prognostic Implications of CYP2C19 Genotype After Drug‐Eluting Stent Implantation.
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