Candidate Gene of NOS3, MMP3, AGT, and AGT1R and Pathway Analyses for Platelet Reactivity and Clinical Outcomes of Repeat Revascularization After First PCI in Chinese Patients

Abstract Purpose Major disadvantages of the percutaneous coronary intervention (PCI) are the high occurrence of repeat revascularization due to restenosis and disease progression. The current study aimed to identify indicators that can predict the risk of repeat revascularization. Methods A total of 143 patients who underwent PCI and had genetic test results were enrolled. We retrospectively reviewed their medical records after the first PCI. P2Y12 reaction units (PRU) test results were obtained by VerifyNow; 372 SNPs of NOS3, MMP3, AGT, and AGT1R gene and 380 genes related to platelet activation-related processes and clopidogrel activity were selected for analysis. Repeat revascularization and in-stent restenosis (ISR) were used as clinical outcomes, and PRU and ADP aggregation rates were used as platelet function outcomes in analysis. Results After the first PCI, the incidence of repeat revascularization at 18, 30, and 42 months was 14.1% (20/142), 17.5% (24/137), and 39.7% (31/78), respectively. In the candidate gene analysis, Rs 78830 (NOS3) was associated with both ADP aggregation rate and 18- and 30-month ISR, and rs 62275847 (AGTR1) was associated with both ADP aggregation rate and 30-month ISR. In the pathway, gene-set analysis, the linkage rs471683 and rs7785386 of GNAI1|GNAT3 were associated with PRU and ADP aggregation rate, 18-months and 30-months ISR, and repeat revascularization within 30 months. Rs1715389 of GNAI1|GNAT3 were associated with both PRU and ADP aggregation rate, 18-months and 30-months ISR, and repeat revascularization within 30 months. Rs7313458 of ITPR2 were associated with PRU and ADP aggregation rate, 18-months and 30-months ISR, and repeat revascularization within 18 months. Conclusions The genetic polymorphisms of rs78830(NOS3), rs62275874 (AGTR1), linkage rs471683 and rs7785386 (GNAI1|GNAT3), rs1715389(GNAI1|GNAT3), and rs7313458 (ITPR2) may lead to an increased risk of in-stent restenosis and revascularization after the first PCI in Chinese patients by affecting the efficacy of clopidogrel. The above six SNP may be used as potential genetic biomarkers for high risk of in-stent restenosis and revascularization after the first PCI in Chinese patients.

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Effects of stent generation on clinical outcomes after acute myocardial infarction compared between prediabetes and diabetes patients

Scientific Reports ◽

10.1038/s41598-021-88593-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yong Hoon Kim ◽

Ae-Young Her ◽

Myung Ho Jeong ◽

Byeong-Keuk Kim ◽

Sung-Jin Hong ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Clinical Outcomes ◽

Secondary Outcome ◽

Drug Eluting Stent ◽

Diabetes Group ◽

Repeat Revascularization ◽

Group A ◽

Group B ◽

Diabetes Patients

AbstractWe investigated the effects of stent generation on 2-year clinical outcomes between prediabetes and diabetes patients after acute myocardial infarction (AMI). A total of 13,895 AMI patients were classified into normoglycemia (group A: 3673), prediabetes (group B: 5205), and diabetes (group C: 5017). Thereafter, all three groups were further divided into first-generation (1G)-drug-eluting stent (DES) and second-generation (2G)-DES groups. Patient-oriented composite outcomes (POCOs) defined as all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization were the primary outcome. Stent thrombosis (ST) was the secondary outcome. In both prediabetes and diabetes groups, the cumulative incidences of POCOs, any repeat revascularization, and ST were higher in the 1G-DES than that in the 2G-DES. In the diabetes group, all-cause death and cardiac death rates were higher in the 1G-DES than that in the 2G-DES. In both stent generations, the cumulative incidence of POCOs was similar between the prediabetes and diabetes groups. However, in the 2G-DES group, the cumulative incidences of Re-MI and all-cause death or MI were significantly higher in the diabetes group than that in the prediabetes group. To conclude, 2G-DES was more effective than 1G-DES in reducing the primary and secondary outcomes for both prediabetes and diabetes groups.

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IMPACT OF RENAL DYSFUNCTION ON RESIDUAL PLATELET REACTIVITY AND CLINICAL OUTCOMES IN PATIENTS WITH ACUTE CORONARY SYNDROME TREATED WITH CLOPIDOGREL

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)01557-6 ◽

2021 ◽

Vol 77 (18) ◽

pp. 198

Author(s):

Qing Li ◽

Yinong Chen ◽

Ying Liu ◽

Luyao Yu ◽

Jingang Zheng ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Renal Dysfunction ◽

Clinical Outcomes ◽

Platelet Reactivity ◽

Coronary Syndrome

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Intermittent concurrent use of clopidogrel and proton pump inhibitors did not increase risk of adverse clinical outcomes in Chinese patients with coronary artery disease

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-01884-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wanbing He ◽

Xiaorong Shu ◽

Enyi Zhu ◽

Bingqing Deng ◽

Yongqing Lin ◽

...

Keyword(s):

Clinical Outcomes ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Cox Regression ◽

Asian Population ◽

Chinese Patients ◽

Clinical Event ◽

Cardiac Events ◽

Concurrent Use ◽

Increased Risk

Abstract Background Proton pump inhibitors (PPIs) are frequently prescribed to patients with coronary heart disease (CHD) under antiplatelet therapy to prevent gastrointestinal (GI) bleeding. However, its clinical impact is still under debate, especially in Asian population. This study was undertaken to explore the effects of concurrent use of clopidogrel and PPIs on the clinical outcomes in Chinese patients with CHD in secondary prevention. Methods A single-center retrospective study was conducted in 638 patients with CHD on consecutive clopidogrel therapy for at least 1 year. After 18-month follow-up, adverse clinical events were collected. Cox regression was used to calculate hazard ratios (HR) and 95% confidence interval (CI) for the effect of PPI use on the outcomes. A total of 638 patients were recruited from 2014 to 2015 in this study, among whom 201 were sustained PPI users, 188 were intermittent PPI users and the remaining 249 were non-PPI users. Results Compared with sustained PPI users, intermittent use of PPIs was associated with a lower risk of stroke, major adverse cardiac events (MACE) and net adverse clinical event (NACE) (stroke: adjusted HR: 0.109, 95% CI 0.014–0.878, p = 0.037; MACE: adjusted HR: 0.293, 95% CI 0.119–0.722; p = 0.008; NACE: adjusted HR: 0.357, 95% CI 0.162–0.786, p = 0.011). Subgroup analysis further revealed the benefit of intermittent PPI use was significant in male CHD patients over 60 years old, with hypertension or chronic kidney disease, and undergoing percutaneous coronary intervention during hospitalization. Conclusion The current findings suggest that the intermittent concurrent use of PPIs and clopidogrel is not associated with an increased risk of 18-month adverse clinical outcomes, and intermittent use of PPIs is associated with a lower rate of MACE and NACE.

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PVRL1 as a Candidate Gene for Nonsyndromic Cleft Lip With or Without Cleft Palate: No Evidence for the Involvement of Common or Rare Variants in Southern Han Chinese Patients

DNA and Cell Biology ◽

10.1089/dna.2011.1556 ◽

2012 ◽

Vol 31 (7) ◽

pp. 1321-1327 ◽

Cited By ~ 1

Author(s):

Hong-Qiu Cheng ◽

En-Min Huang ◽

Ming-Yan Xu ◽

Shen-You Shu ◽

Shi-Jie Tang

Keyword(s):

Cleft Palate ◽

Candidate Gene ◽

Cleft Lip ◽

Rare Variants ◽

Han Chinese ◽

Chinese Patients

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COMPARISON OF PLATELET REACTIVITY AND CLINICAL OUTCOMES IN PATIENTS TREATED WITH CLOPIDOGREL AND CORONARY INTERVENTION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(14)60224-2 ◽

2014 ◽

Vol 63 (12) ◽

pp. A224

Author(s):

Min Kim ◽

Sang Yeub Lee ◽

Ju-Hee Lee ◽

Sang Min Kim ◽

Jang-Whan Bae ◽

...

Keyword(s):

Clinical Outcomes ◽

Platelet Reactivity ◽

Coronary Intervention

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Abstract 11526: Intraprocedural Thrombotic Events During PCI for ACS Are Associated With Increased Adverse Ischemic Events at 30 Days: A Meta-Analysis of Randomized Trials

Circulation ◽

10.1161/circ.130.suppl_2.11526 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Ramez Nairooz ◽

Partha Sardar ◽

Saurav Chatterjee ◽

Zubair Ahmed ◽

Dmitriy N Feldman

Keyword(s):

Clinical Outcomes ◽

Stent Thrombosis ◽

Literature Search ◽

Randomized Trials ◽

Meta Analysis ◽

Major Adverse Cardiovascular Events ◽

Repeat Revascularization ◽

Coronary Syndrome ◽

Reported Data ◽

Ischemic Events

Background: Data regarding intraprocedural thrombotic events (IPTE) including slow reflow or no reflow, distal embolization, intraprocedural stent thrombosis and abrupt vessel closure during PCI for acute coronary syndrome (ACS) are scarce. Their association with subsequent adverse ischemic events needs further investigation. Aim: To evaluate effect of IPTE on in-hospital and at 30-days clinical outcomes after PCI for ACS. Hypothesis: IPTE during PCI are associated with adverse ischemic events while in-hospital and at 30 days. Methods: We performed a literature search of all published full-length articles of randomized trials that reported data on patients with IPTE compared with no IPTE during PCI for patients with ACS. We calculated odd ratios via random effects model for in-hospital ischemic outcomes and 30 day outcomes. Results: Our literature search yielded 3 randomized trials reporting clinical outcomes with IPTE and no IPTE for ACS patients undergoing PCI: ACUITY, HORIZONS-AMI and EARLY-ACS trials. We report clinical outcomes (in-hospital and at 30 days) in 8,043 patients in total, of those 673 had IPTE. At 30 days, patients with IPTE had more major adverse cardiovascular events (MACE) (Odds ratio (OR) 3.97, 95% Confidence interval (CI) [1.81-8.69]; p=0.0006), mortality (OR 4.54, 95% CI [1.99, 10.39]; p=0.0003), myocardial infarction (OR 4.54, 95% CI [1.99, 10.39]; p=0.0003), repeat revascularization (OR 4.54, 95% CI [1.99, 10.39]; p=0.0003), total stent thrombosis (OR 4.54, 95% CI [1.99, 10.39]; p=0.0003) and non-CABG related major bleeding (OR 4.54, 95% CI [1.99, 10.39]; p=0.0003) than those with no IPTE. Similarly, in-hospital clinical outcomes were all significantly higher in patients with IPTE than those without. Conclusion: IPTE during PCI is associated with more adverse ischemic events, including mortality, both in-hospital and at 30 days.

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