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Article

Impact of CYP2C19 Gene Variants on Long-Term Treatment with Atorvastatin in Patients with Acute Coronary Syndromes

by
Darius Čereškevičius
1,
Vytautas Zabiela
1,
Ali Aldujeli
1,
Vaiva Lesauskaitė
1,
Kristina Zubielienė
2,
Vytautas Raškevičius
1,
Ieva Čiapienė
1,
Diana Žaliaduonytė
2,
Agnė Giedraitienė
3,
Vaidotas Žvikas
4,
Valdas Jakštas
4,
Vilius Skipskis
1,
Olivija Dobilienė
5,
Gintarė Šakalytė
1 and
Vacis Tatarūnas
1,*
1
Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu 15, LT 50103 Kaunas, Lithuania
2
Department of Cardiology, Kaunas Hospital of the Lithuanian University of Health Sciences, Hipodromo 13, LT 45130 Kaunas, Lithuania
3
Institute of Microbiology and Virology, Lithuanian University of Health Sciences, Eivenių 4, LT 50161 Kaunas, Lithuania
4
Institute of Pharmaceutical Technologies, Sukileliu 13, LT 50103 Kaunas, Lithuania
5
Department of Cardiology, Lithuanian University of Health Sciences, Eivenių 2, LT 50009 Kaunas, Lithuania
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2024, 25(10), 5385; https://doi.org/10.3390/ijms25105385
Submission received: 4 April 2024 / Revised: 2 May 2024 / Accepted: 12 May 2024 / Published: 15 May 2024
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)
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Abstract

The effectiveness of lipid-lowering therapies may be insufficient in high-risk cardiovascular patients and depends on the genetic variability of drug-metabolizing enzymes. Customizing statin therapy, including treatment with atorvastatin, may improve clinical outcomes. Currently, there is a lack of guidelines allowing the prediction of the therapeutic efficacy of lipid-lowering statin therapy. This study aimed to determine the effects of clinically significant gene variants of CYP2C19 on atorvastatin therapy in patients with acute coronary syndromes. In total, 92 patients with a confirmed diagnosis of ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI) were sequenced for target regions within the CYP2C19 gene on the Illumina Miniseq system. The CYP2C19 poor metabolizer phenotype (carriers of CYP2C19*2, CYP2C19*4, and CYP2C19*8 alleles) was detected in 29% of patients. These patients had significantly lower responses to treatment with atorvastatin than patients with the normal metabolizer phenotype. CYP2C19-metabolizing phenotype, patient age, and smoking increased the odds of undertreatment in patients (∆LDL-C (mmol/L) < 1). These results revealed that the CYP2C19 phenotype may significantly impact atorvastatin therapy personalization in patients requiring LDL lipid-lowering therapy.
Keywords: statins; atorvastatin; LDL cholesterol; CYP2C19; STEMI; NSTEMI statins; atorvastatin; LDL cholesterol; CYP2C19; STEMI; NSTEMI

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MDPI and ACS Style

Čereškevičius, D.; Zabiela, V.; Aldujeli, A.; Lesauskaitė, V.; Zubielienė, K.; Raškevičius, V.; Čiapienė, I.; Žaliaduonytė, D.; Giedraitienė, A.; Žvikas, V.; et al. Impact of CYP2C19 Gene Variants on Long-Term Treatment with Atorvastatin in Patients with Acute Coronary Syndromes. Int. J. Mol. Sci. 2024, 25, 5385. https://doi.org/10.3390/ijms25105385

AMA Style

Čereškevičius D, Zabiela V, Aldujeli A, Lesauskaitė V, Zubielienė K, Raškevičius V, Čiapienė I, Žaliaduonytė D, Giedraitienė A, Žvikas V, et al. Impact of CYP2C19 Gene Variants on Long-Term Treatment with Atorvastatin in Patients with Acute Coronary Syndromes. International Journal of Molecular Sciences. 2024; 25(10):5385. https://doi.org/10.3390/ijms25105385

Chicago/Turabian Style

Čereškevičius, Darius, Vytautas Zabiela, Ali Aldujeli, Vaiva Lesauskaitė, Kristina Zubielienė, Vytautas Raškevičius, Ieva Čiapienė, Diana Žaliaduonytė, Agnė Giedraitienė, Vaidotas Žvikas, and et al. 2024. "Impact of CYP2C19 Gene Variants on Long-Term Treatment with Atorvastatin in Patients with Acute Coronary Syndromes" International Journal of Molecular Sciences 25, no. 10: 5385. https://doi.org/10.3390/ijms25105385

APA Style

Čereškevičius, D., Zabiela, V., Aldujeli, A., Lesauskaitė, V., Zubielienė, K., Raškevičius, V., Čiapienė, I., Žaliaduonytė, D., Giedraitienė, A., Žvikas, V., Jakštas, V., Skipskis, V., Dobilienė, O., Šakalytė, G., & Tatarūnas, V. (2024). Impact of CYP2C19 Gene Variants on Long-Term Treatment with Atorvastatin in Patients with Acute Coronary Syndromes. International Journal of Molecular Sciences, 25(10), 5385. https://doi.org/10.3390/ijms25105385

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