Clinical Value of CYP2C19 Polymorphisms for Guiding the Anti-platelet Therapy in CAD patients After Percutaneous Coronary Intervention
10.3969/j.issn.1000-3614.2015.03.005
- VernacularTitle:冠心病患者支架术后根据检测药物代谢酶CYP2C19基因调整抗血小板治疗的价值
- Author:
Dan WU
;
Shengli YANG
;
Jing LU
;
Jie HUANG
;
Yaqin SUN
- Publication Type:Journal Article
- Keywords:
CYP2C19 gene;
Clopidogrel;
Ticagrelor;
Percutaneous coronary intervention;
Platelet aggregation;
Major adverse cardiac events
- From:
Chinese Circulation Journal
2015;(3):216-219
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the value of CYP2C19 genotype polymorphisms for guiding the strategy of anti-platelet therapy in coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI) with clinical prognosis.
Methods: A total of 326 CAD patients with PCI treatment received CYP2C19 genotype examination. According to CYP2C19 polymorphisms, the patients were divided into 3 groups. The patients with CYP2C19*1/*1, fast metabolism were defined as Routine group, who received clopidogrel 75 mg/day,n=128. The patients with CYP2C19*1/*2, CYP2C19*1/*3, CYP2C19*2/*3, CYP2C19*2/*2, CYP2C19*3/*3, medium and slow metabolism were further divided into 2 groups as High clopidogrel group, who received clopidogrel 150 mg/day,n=99 and Ticagrelor group, who received ticagrelor 90 mg/bid,n=99. The changes of platelet aggregation rate (PAgT) at before and 1, 3, 6 months after PCI were observed, the major adverse cardiac events (MACE) and bleeding condition were compared among different groups at 6 months after PCI.
Results: The PAgT was similar between High clopidogrel group and Routine group at 1, 3, 6 months after PCI, P>0.05;while compared with High clopidogrel group and Routine group, the PAgT decreased in Ticagrelor group at 1, 3, 6 months after PCI,P<0.05. The occurrence of MACE was similar between High clopidogrel group and Routine group at 6 months after PCI,P>0.05; while compared with High clopidogrel group and Routine group, Ticagrelor group had much less MACE occurrence,P<0.05. Ticagrelor group had no more major bleeding events than the other 2 groups,P>0.05.
Conclusion: High dose clopidogrel does not increase MACE occurrence in CAD patients with CYP2C19 medium and slow metabolism after PCI. Ticagrelor may decrease PAgT and MACE occurrence without elevating the major bleeding events.
