{"doi":"10.3390/genes11091068","title":"Effect of CYP3A4*22 and PPAR-α Genetic Variants on Platelet Reactivity in Patients Treated with Clopidogrel and Lipid-Lowering Drugs Undergoing Elective Percutaneous Coronary Intervention","abstract":"This study aims to determine whether genetic variants that influence CYP3A4 expression are associated with platelet reactivity in clopidogrel-treated patients undergoing elective percutaneous coronary intervention (PCI), and to evaluate the influence of statin/fibrate co-medication on these associations. A study cohort was used containing 1124 consecutive elective PCI patients in whom CYP3A4*22 and PPAR-α (G209A and A208G) SNPs were genotyped and the VerifyNow P2Y12 platelet reactivity test was performed. Minor allele frequencies were 0.4% for CYP3A4*22/*22, 6.8% for PPAR-α G209A AA, and 7.0% for PPAR-α A208G GG. CYP3A4*22 was not associated with platelet reactivity. The PPAR-α genetic variants were significantly associated with platelet reactivity (G209A AA: −24.6 PRU [−44.7, −4.6], p = 0.016; A208G GG: −24.6 PRU [−44.3, −4.8], p = 0.015). Validation of these PPAR-α results in two external cohorts, containing 716 and 882 patients, respectively, showed the same direction of effect, although not statistically significant. Subsequently, meta-analysis of all three cohorts showed statistical significance of both variants in statin/fibrate users (p = 0.04 for PPAR-a G209A and p = 0.03 for A208G), with no difference in statin/fibrate non-users. In conclusion, PPAR-α G209A and A208G were associated with lower platelet reactivity in patients undergoing elective PCI who were treated with clopidogrel and statin/fibrate co-medication. Further research is necessary to confirm these findings.","journal":"Genes","year":2020,"id":107529,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9261,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":516611,"name":"Alfi Yasmina","orcid":"0000-0002-2337-713X","position":1,"is_corresponding":false},{"id":517172,"name":"Gerrit J.A. Vos","orcid":null,"position":2,"is_corresponding":false},{"id":516612,"name":"Paul W.A. Janssen","orcid":"0000-0003-1976-1515","position":3,"is_corresponding":false},{"id":517173,"name":"Christian M. Hackeng","orcid":null,"position":4,"is_corresponding":false},{"id":55563,"name":"Johannes C. Kelder","orcid":"0000-0002-8143-5078","position":5,"is_corresponding":false},{"id":98506,"name":"Shefali S. Verma","orcid":"0000-0001-5216-4670","position":6,"is_corresponding":false},{"id":22049,"name":"Marylyn D. Ritchie","orcid":"0000-0002-1208-1720","position":7,"is_corresponding":false},{"id":11035,"name":"Li Gong","orcid":"0000-0002-1739-8233","position":8,"is_corresponding":false},{"id":11029,"name":"Teri E. Klein","orcid":"0000-0001-5527-6475","position":9,"is_corresponding":false},{"id":517174,"name":"ICPC investigators","orcid":null,"position":10,"is_corresponding":false},{"id":79286,"name":"Anthonius de Boer","orcid":"0000-0002-9485-8037","position":11,"is_corresponding":false},{"id":517175,"name":"Olaf H. Klungel","orcid":null,"position":12,"is_corresponding":false},{"id":348258,"name":"Jurriën M. ten Berg","orcid":"0000-0001-5192-886X","position":13,"is_corresponding":false},{"id":516613,"name":"Vera H.M. Deneer","orcid":"0000-0002-8564-4424","position":14,"is_corresponding":false},{"id":348243,"name":"Thomas O. Bergmeijer","orcid":"0000-0002-7900-9926","position":0,"is_corresponding":true}],"reference_count":33,"raw_metadata":null,"created_at":"2026-07-18T23:12:34.898963Z","pmid":"32932966","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}