Blood direct PCR: impact of CYP2C19 and CYP4F2 variants for bleeding prediction in ST-elevation myocardial infarction patients with ticagrelor

• Main Authors: Aldujeli, A. (Author), Baksyte, G. (Author), Burkanas, M. (Author), Ciapiene, I. (Author), Giedraitiene, A. (Author), Gustiene, O. (Author), Kurnickaite, Z. (Author), Lesauskaite, V. (Author), MacIulevicius, L. (Author), Norvilaite, R. (Author), Sakalyte, G. (Author), Skipskis, V. (Author), Tatarunas, V. (Author), Unikas, R. (Author), Venius, J. (Author)
• Format: Article
• Language: English
• Published: Future Medicine Ltd. 2022
• Subjects: acute coronary syndrome; antiplatelets; blood direct PCR; CYP2C19; CYP4F2; personalization; STEMI; ticagrelor
• Online Access: View Fulltext in Publisher
• ISBN: 17410541 (ISSN)
• DOI: 10.2217/pme-2021-0152

Aims: The goals of this study were to develop a new technique that could pave the way for a quicker determination of CYP4F2 rs3093135 and CYP2C19 rs4244285 variants directly from a patient's blood and to attempt to apply this technique in clinical practice. Patients & methods: The study included 144 consecutive patients admitted with ST elevation myocardial infarction. A blood-direct PCR and real-time PCR were used to detect variants of interest. Results & conclusion: Patients with bleeding events had the CYP2C19 GG (*1*1) variant more frequently than patients without bleeding events. The CYP4F2 TT variant was more frequently detected in patients with bleeding events 3 months after hospitalization. Plain language summary Ticagrelor is one of the main antiplatelet drugs used for prevention of coronary blood clots after interventional procedures in patients with acute coronary syndromes. It has previously been shown that gene variants of CYP2C19 and CYP4F2 may affect antiplatelet therapy. This paper reports a novel instrument and the results of genetic tests obtained using this instrument. Our instrument can detect variants of the genes associated with ticagrelor antiplatelet therapy in only 40 min. These findings might facilitate individualized treatment with ticagrelor of patients with ST-elevation myocardial infarction. © 2022 Vacis Tatarunas.