Intra-Stent Thrombus Early After Stent Implantation is Associated With Cytochrome P450 2C19 Genotypes in Clopidogrel-Treated Patients

Background: Cytochrome P450 (CYP) 2C19 polymorphism is associated with poor responsiveness to clopidogrel. This study aimed to clarify the relationship between CYP2C19 polymorphism and the incidence of intra-stent thrombus at early phase after drug-eluting stent (DES) implantation in patients treated with dual antiplatelet therapy (DAPT) with aspirin and clopidogrel. Methods: We analyzed optical coherence tomography (OCT) imaging from 53 DESs of 25 patients both immediately after and early (33.5+/-18.8 days) after percutaneous coronary intervention. Implanted stents were second or third generation DES. All patients were treated with DAPT with aspirin and clopidogrel. Based on the CYP2C19 genotypes, patients were classified into three phenotype groups; extensive metabolizers (EMs), intermediate metabolizers (IMs) or poor metabolizers (PMs). We evaluated the relationship between the percentage of intra-stent thrombus and CYP2C19 phenotypes. Results: The numbers of patients and stents implanted in each EMs, ...