A Pharmacogenetic Panel-Based Prediction of the Clinical Outcomes in Elderly Patients with Coronary Artery Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Clinical Characteristics
2.2. Drug–Gene Pair Selection
2.3. Multiplexed Targeted Panel Genotyping
2.4. Clinical Outcomes
2.5. Statistical Analysis
3. Results
3.1. Baseline Clinical Characteristics
3.2. Pharmacogenetic Variants and Genotypes
3.3. Distribution of Drug–Gene Pairs
3.4. Association between Drug–Gene Pairs and Clinical Outcomes
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | n = 892 |
---|---|
Demographics | |
Gender (Male), n (%) | 551 (61.8%) |
Age (years), mean (SD) | 80.7 (5.2) |
BMI (kg/m2), Mean (SD) | 24.4 (3.6) |
Smoking, n (%) | 88 (9.9%) |
Drinking, n (%) | 166 (18.6%) |
Comorbidities | |
Number of comorbidities, n (%) | |
2 | 239 (26.8%) |
3 | 283 (31.8%) |
4 | 210 (23.5%) |
≥5 | 160 (17.9%) |
Myocardial infarction, n (%) | 131 (14.7%) |
Heart failure, n (%) | 73 (8.2%) |
Hypertension, n (%) | 720 (80.7%) |
Diabetes mellitus, n (%) | 378 (42.4%) |
Hyperlipidemia, n (%) | 210 (23.5%) |
Stroke, n (%) | 170 (19.1%) |
Hepatic and renal insufficiency, n (%) | 133 (14.9%) |
PCI, n (%) | 334 (37.4%) |
Drugs at discharge | |
Number of drugs/patient, median (IQR, range) | 7 (6–8, 5–13) |
Antiplatelet agents, n (%) | 827 (92.7%) |
Oral anticoagulation agents, n (%) | 97 (10.9%) |
Lipid-lowering agents, n (%) | 837 (93.8%) |
Calcium channel blockers, n (%) | 403 (45.2%) |
Beta blockers, n (%) | 569 (63.8%) |
ACEI, n (%) | 39 (4.4%) |
ARB, n (%) | 280 (31.4%) |
Diuretic, n (%) | 263 (29.4%) |
PPI, n (%) | 562 (63.0%) |
Folic acid, n (%) | 47 (5.3%) |
All-Cause Mortality | MACEs | ADRs | Readmission | |||||
---|---|---|---|---|---|---|---|---|
HR (95% CI) | p Value | HR (95% CI) | p Value | HR (95% CI) | p Value | HR (95% CI) | p Value | |
Univariate analysis | ||||||||
Number of drug–gene pairs | 0.869 (0.753–1.004) | 0.057 | 0.821 (0.700–0.962) | 0.015 | 1.150 (1.016–1.302) | 0.027 | 1.076 (0.960–1.206) | 0.208 |
Increased efficacy | 0.894 (0.725–1.103) | 0.297 | 0.788 (0.623–0.996) | 0.046 | 1.219 (1.017–1.460) | 0.032 | 1.001 (0.847–1.184) | 0.987 |
Decreased efficacy | 0.792 (0.626–1.002) | 0.052 | 0.795 (0.616–1.027) | 0.079 | 1.133 (0.927–1.386) | 0.223 | 1.211 (1.006–1.458) | 0.043 |
Multivariable analysis | ||||||||
Number of drug–gene pairs | 0.848 (0.722–0.996) | 0.045 | 0.803 (0.683–0.945) | 0.008 | 1.170 (1.030–1.329) | 0.016 | 1.074 (0.955–1.208) | 0.232 |
Increased efficacy | 0.933 (0.739–1.179) | 0.563 | 0.777 (0.611–0.989) | 0.044 | 1.235 (1.026–1.485) | 0.025 | 0.990 (0.833–1.176) | 0.905 |
Decreased efficacy | 0.704 (0.540–0.918) | 0.010 | 0.761 (0.586–0.989) | 0.041 | 1.161 (0.945–1.425) | 0.155 | 1.222 (1.010–1.478) | 0.039 |
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Dong, L.; Zhang, S.; Lv, C.; Xue, Q.; Yin, T. A Pharmacogenetic Panel-Based Prediction of the Clinical Outcomes in Elderly Patients with Coronary Artery Disease. Pharmaceutics 2024, 16, 1079. https://doi.org/10.3390/pharmaceutics16081079
Dong L, Zhang S, Lv C, Xue Q, Yin T. A Pharmacogenetic Panel-Based Prediction of the Clinical Outcomes in Elderly Patients with Coronary Artery Disease. Pharmaceutics. 2024; 16(8):1079. https://doi.org/10.3390/pharmaceutics16081079
Chicago/Turabian StyleDong, Lisha, Shizhao Zhang, Chao Lv, Qiao Xue, and Tong Yin. 2024. "A Pharmacogenetic Panel-Based Prediction of the Clinical Outcomes in Elderly Patients with Coronary Artery Disease" Pharmaceutics 16, no. 8: 1079. https://doi.org/10.3390/pharmaceutics16081079