CYP2C19 genotype-guided antiplatelet therapy in elderly patients with acute coronary syndrome after percutaneous coronary intervention
10.3760/cma.j.issn.0254-9026.2020.10.015
- VernacularTitle:老年急性冠状动脉综合征CYP2C19基因中代谢型冠脉介入治疗术后患者抗血小板策略
- Author:
Yan CHEN
1
;
Hao YANG
;
Jie GAO
;
Jiayi SUN
;
Xuefang YU
;
Guoyan ZHAO
;
Qing YANG
;
Wenjuan ZHANG
Author Information
1. 天津医科大学总医院心内科，天津 300052
- From:
Chinese Journal of Geriatrics
2020;39(10):1170-1173
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate optimal antiplatelet therapy options based on the CYP2C19 genotype in elderly patients with acute coronary syndrome(ACS).Methods:Elderly patients with ACS admitted to our hospital from January 2018 to March 2019 were enrolled and received CyP2C19 gene testing.Patients with the intermediate metabolic genotype of CYP2C19 were randomly divided into two groups: the Ticagrelor group and the double-dose Clopidogrel group.After a one-year follow-up, the risk of bleeding and incidences of cardiovascular events in the two groups were analyzed.Results:468 elderly patients meeting the criteria, 214 had the intermediate metabolic genotype of CYP2C19, accounting for 45.7% of the total, and were randomly divided into the ticagrelor treatment group( n=107)and the double-dose Clopidogrel treatment group( n=107). There were significant differences between the Ticagrelor treatment group and the double-dose Clopidogrel treatment group in incidences of minor bleeding, massive hemorrhage, recurrent angina and recurrent acute myocardial infarction(11.2% vs.22.4%, 2.8% vs. 9.4 %, 4.7% vs.13.1%, 3.7% vs. 11.2%, P<0.05). The double-dose Clopidogrel group not only had a higher risk of cardiovascular events, but also a higher risk of bleeding. Conclusions:For elderly ACS patients with the intermediate metabolic genotype of CYP2C19, a standard dose of ticagrelor is recommended.
