Research on detection method and clinical countermeasure of clopidogrel-resisted metabolism-related genes after interventional operation of coronary heart disease (CHD)
10.3760/cma.j.issn.1008-1372.2015.07.019
- VernacularTitle:冠心病介入术后氯吡格雷抵抗的代谢相关基因检测及临床对策研究
- Author:
Jun HE
;
Yanhong ZHANG
;
Zhiping GOU
;
Yan WANG
;
Xiaoli SUN
;
Xiaohua LI
- Publication Type:Journal Article
- Keywords:
Cytochrome P-450 enzyme system/GE/ME;
Polymorphism,single nucleotide;
Angioplasty,transluminal,percutaneous coronary;
Ticlopidine/AA/TU;
Drug resistance;
Coronary disease
- From:
Journal of Chinese Physician
2015;17(7):1019-1023
- CountryChina
- Language:Chinese
-
Abstract:
Objective Study on cytochrome P450 (CYP) 2C19 gene single nucleotide polymorphism and the clinical prognosis of coronary heart disease (CHD) patients with percutaneous coronary intervention (PCI) after long-term use of clopidogrel.Methods A total of 150 cases of CHD patients was chosen prospectively between January 2013 and June 2014 who were hospitalized and PCI.All patients accepted dual antiplatelet therapy.Platelet aggregation rate and platelet aggregation inhibition rate were detected before taking the medicine and after PCI,which were used to classify the patients into clopidogrel-resistance groups (CR) and non-clopidogrel-resistance group (NCR).CYP2C19 gene single nucleotide polymorphism type was determined.The patients in CR group accepted clinical intervention countermeasures and NCR group was used as control,and postoperative recurrence angina and bleeding at the one year of operation were observed.Results About 24.67％ of patients with CHD with clopidogrel treatment,platelet aggregation rate cannot recover to normal.The correlation analysis showed CYP2C19* 2 carriers had a significantly higher platelet aggregation rate.Comprehensive analysis found that CYP2C19 * 2,long-term smoking,increased platelet count,and diabetes were the independent risk factors that platelet aggregation rate cannot recover to normal.No significant differences were found in primary end point,secondary end points,and bleeding events between CR group after clinical intervention countermeasures and NCR group.Conclusions CYP2C19 * 2,long-term smoking,increased platelet count,and diabetes are the independent risk factors that platelet aggregation rate cannot be developed to standard.Patients with clopidogrel resistance,the clinical intervention countermeasures to strengthen antiplatelet therapy can improve high platelet reactivity after PCI in CHD patients,and does not increase the risk of bleeding.
