Association between CYP2C19*2/*3Polymorphisms and Coronary Heart Disease

This study sought to explore the relationship between cytochrome P450 2C19(CYP2C19)*2/*3 polymorphisms and the development of coronary heart disease(CHD),and to evaluate the influence of the single nucleotide polymorphisms(SNPs)on the occurrence of adverse clinical events in CHD patients.A total of 231 consecutive patients candidate for percutaneous coronary intervention genotyped for CYP2C19*2(681G>A)and*3(636G>A)polymorphisms were enrolled.The adverse clinical events were recorded during a follow-up period of 14 months.The incidence of CHD,according to coronary angiography,was significantly higher(P=0.025)in CYP2C19*2 carriers group.Stepwise binary logistic regression analysis revealed that among factors that potentially influenced the presence of CHD(age>60 years,gender,BMI,etc.),CYP2C19*2 carriers(OR 1.94,95%CI:1.08-3.50,P=0.028)and male gender(OR 2.74,95%CI:1.58-4.76,P=0.001)were independent predictors,which were associated with the presence of CHD.The follow-up results showed that the incidence of adverse cardiovascular events within 14 months of discharge was significantly higher in the CYP2C 19*2 carriers than in the non-carriers(21.6%vs.6.3%,P=0.019).The results of the multivariate Cox proportional hazards model showed that CYP2C19*2 loss-of-flinction was the only independent factor which predicted the coronary events during the follow-up period of 14 months(OR=3.65,95%CI:1.09-12.25,P=0.036).The adverse impact of CYP2C19*2 polymorphisms was found not only in the risk of the presence of CHD,but also in the adverse cardiovascular events in CHD patients during the follow-up period of 14 months.However the same influence was not found in CYP2C19*3 mutation in Chinese Han population.

Long-term effect of a large dose of iodinated contrast in patients with mild thyroid dysfunction:a prospective cohort study

Background:More than 75 million procedures with intravascular iodine-based contrast media(ICM)are performed worldwide every year,and some patients undergoing these procedures do not have normal thyroid function.The long-term effects of ICM in patients with mild thyroid dysfunction(TD)are unclear.Methods:This prospective cohort study was conducted in China.Patients with stable angina pectoris with total triiodothyronine(TT3)reduction,normal thyroid-stimulating hormone,and reverse triiodothyronine(rT3)were enrolled and divided into high-dose(≥100 mL ICM)and low-dose groups(<100 mL ICM).We dynamically investigated the trends in thyroid function,rT3,and thyroid antibodies one year after ICM exposure.Results:A total of 154 patients completed 6 months of follow-up and 149 completed 1 year of follow-up.Thyroglobulin antibody(TGAB)levels were elevated in 41(26.6%)patients before ICM exposure,11(7.1%)of whom also had elevated thyroid peroxidase antibody levels.Transient subclinical TD occurred 6 months after ICM exposure;75.5%(34/45)of post-operative TD occurred in the high-dose group.One patient developed severe hypothyroidism with myxedema,requiring drug intervention 1 year after ICM exposure.The level of rT3 showed no statistically significant changes during post-operative follow-up(P=0.848).The TGAB level decreased at 6th month(P<0.001),but increased at 1 year after ICM exposure(P=0.002).Conclusions:Patients with T3 reduction are at a risk of transient subclinical TD and hypothyroidism after a single large dose of ICM.Follow-up of this population at 9-12 months after ICM exposure is warranted.