Value of CYP2C19 gene polymorphism combined with biochemical indicators in predicting clopidogrel resistance in patients with cerebral infarction
10.3969/j.issn.1673-4130.2024.23.003
- VernacularTitle:CYP2C19基因多态性联合生化指标预测脑梗死患者氯吡格雷抵抗的价值分析
- Author:
Kelin CHEN
1
;
Jiarong LIU
;
Ziwei LIU
;
Yufei WANG
;
Siwen LI
;
Jin ZHOU
;
Shujing LIU
;
Guojun ZHANG
Author Information
1. 首都医科大学附属北京天坛医院检验科/北京市免疫试剂临床工程技术研究中心/国家药品监督管理局体外诊断试剂质量控制重点实验室,北京 100070
- Keywords:
CYP2C19 gene polymorphism;
clopidogrel resistance;
cerebral infarction;
biochemical indicators
- From:
International Journal of Laboratory Medicine
2024;45(23):2829-2833
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the value of CYP2C19 gene polymorphism combined with biochemical indi-cators in predicting clopidogrel resistance(CR)in patients with cerebral infarction.Methods A total of 387 patients with cerebral infarction admitted to Beijing Tiantan Hospital,Capital Medical University from Januar-y 2021 to December 2023 were selected as the research subjects.According to the test results of platelet aggre-gation test-adenosine diphosphate(PAgT-ADP)after admission,the patients with cerebral infarction were di-vided into clopidogrel effective group(PAgT-ADP≤43％)and CR group(PAgT-ADP＞43％).The distribu-tion of CYP2C19 genotype in patients with cerebral infarction were observed.The age,gender and biochemical indicators,including urea,creatinine(Cr),uric acid(UA),alanine aminotransferase(ALT),aspartate amin-otransferase(AST),total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),lactate dehydro-genase(LDH),triglycerides(TG),total cholesterol(CHO),high-density lipoprotein cholesterol(HDL),low-density lipoprotein cholesterol(LDL),homocysteine(Hcy),of the two groups were retrospectively analyzed.Single factor analysis was conducted on statistical indicators,and a combined prediction model was constructed through multivariate Logistic regression analysis.Receiver operating characteristic(ROC)curve was plotted to analyze the efficacy of CYP2C19 gene metabolic types alone and in combination with biochemical indicators for predicting CR in patients with cerebral infarction.Results The gender,Cr,TBIL,DBIL,IBIL,Hcy and CYP2C19 gene metabolic types showed statistically significant differences between the CR group and the clo-pidogrel effective group(P＜0.05).Multivariate Logistic regression analysis showed that Cr,ALT,AST,TBIL,DBIL,IBIL,CHO,LDL and CYP2C19 gene metabolic types were independent predictors of CR(P＜0.05).ROC curve analysis results showed that the area under the curve of the combined prediction model for predicting CR in patients with cerebral infarction was 0.720,and the sensitivity and the specificity were 71.1％and 65.5％,respectively.The area under the curve of the CYP2C19 gene metabolic types for predicting CR in patients with cerebral infarction alone was 0.641,and the sensitivity and the specificity were 67.3％and 56.9％,respectively.There was a statistically significant difference in the area under the curve between the combined prediction model and the CYP2C19 gene metabolic type alone(P＜0.05).Conclusion The combi-nation of CYP2C19 gene polymorphism and biochemical indicators is helpful in predicting the occurrence of CR in patients with cerebral infarction,and has good predictive value especially for patients with CR and CYP2C19 gene metabolism showing normal metabolism.
