Correlation Study of CYP2C19 Genotypes on Peri-procedural Myocardial Infarction in Patients With Percutaneous Coronary Intervention
10.3969/j.issn.1000-3614.2016.08.004
- VernacularTitle:CYP2C19基因型对经皮冠状动脉介入治疗后围术期心肌梗死的相关性研究
- Author:
Hong CHEN
;
Hui CHEN
- Publication Type:Journal Article
- Keywords:
Angioplasty,transluminal,percutaneous coronary;
Peri-procedural myocardial injury;
CYP2C19 genotypes
- From:
Chinese Circulation Journal
2016;31(8):742-745
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To analyze the risk factors for peri-procedural myocardial infarction (PMI) in patients with percutaneous coronary intervention (PCI) and to study the impact of CYP2C19 genotypes on PMI. Methods: A total of 283 coronary artery disease (CAD) patients received elective PCI were enrolled, the patients were with normal level of cTnI prior PCI, without adverse reaction post PCI and cTnI levels were re-examined at 24 hours after PCI. The patients were divided into 2 groups: PMI group,n=83 and Non-PMI group,n=200. CYP2C19 genotypes were detected by DNA microarray chip method and based on its result, the patients were classiifed into 3 genotypes: Extensive metabolism type, Intermediate metabolism type and Poor metabolism type. The patients with ADP inhibition rate ≤ 20% was deifned as heightened platelet reactivity (HPR) which was measured by thrombelastograph. Baseline clinical condition was compared between 2 groups and the impact of CYP2C19 genotypes with other risk factors for PMI occurrence were studied. Results: The occurrence rate of PMI was 29.3% (83/283); the age, gender, BMI, smoking, blood levels of TG, LDL-C and uric acid, history of hypertension and diabetes were similar between 2 groups,P>0.05. Compared with Non-PMI group, PMI group had more implanted stents (2.1 ± 0.9) vs (1.5 ± 0.6) and longer total length of stents 56 (36-71) mm vs 33 (23-51) mm, bothP<0.05; lower ADP inhibition rate (36.0 ± 29.8) % vs (43.9 ± 26.4) %,P=0.02 and higher HPR occurrence rate 39.8% vs 22.0%,P=0.01. The ratios of CYP2C19 genotypes of Extensive metabolism, Intermediate metabolism and Poor metabolism were 37.5%, 45.2% and 17.3% respectively, while PMI patients in each genotype were 21.7%, 29.7% and 44.9% respectively. Logistic regression analysis indicated that HPR (OR=2.18, 95% CI 1.19-4.01,P=0.02), total length of stents (OR=1.03, 95% CI 1.00-1.06,P=0.007) and CYP2C19 Poor metabolism genotype (OR=2.8, 95% CI 1.24-6.28,P=0.01) were the risk factors for PMI occurrence. Conclusion: HPR, total length of stents and CYP2C19 poor metabolism genotype were the risk factors of PMI occurrence, while poor metabolism genotype might be the most important endogenous reason for PMI occurrence.
