The impact of genetic polymorphisms of CYP2C19*2 and GPIIIa on clopidogrel responsiveness in Han popula-tion of Guangzhou with coronary heart disease

HE Yong-cong; LI Ai-qun; LIU Ben-rong; JIN Li-jun; OU Wen-chao

Abstract：Objective To investigate the distribution of genotype frequencies of CYP2C19*2 and GPIIIa genetic polymorphisms in Han population of GuangZhou with coronary heart disease and the impact on the clopidogrel responsive-ness. Methods A total of 146 patients confirmed with coronary heart disease(CHD)by coronary angiography were en-rolled,and clopidogrel(75mg daily)were given for more than 5 days. According to maximum platelet aggregation rate (MPA),patients were divided into the high on - treatment platelet reactivity(HTPR)group(MPA≥50% )and the nor-mal group. Polymerase chain reaction( PCR)and DNA sequencing methods were used to detect the genotypes of the G681A and T1565C. The distributions of the frequencies of genotypes and alleles,the clinical indexes and the incidence of adverse cardiovascular events were analyzed. Results Significant differences in genotype frequencies of CYP2C19*2 (G681A)were observed between the two groups(P < 0. 05). Frequency of A allele was significantly higher in HTPR group than that in normal group(P < 0. 05),and A allele carriers were more likely to develop HTPR(OR = 1. 91,95%CI:1. 091 -3. 344,P <0. 05). According to logistic regression analysis adjusted for the clinical indexes,the CYP2C19*2(G681A)genetic polymorphisms resulted as independent risk factor for HTPR(OR = 2. 837,95% CI:1. 246 - 6. 458, P < 0. 05). There was no significant difference between two groups in the genotype or allele frequency of GPIIIa (T1565C). Conclusion CYP2C19*2(G681A)genetic polymorphisms is closely associated with the occurrence of HT-PR and may impact the responsiveness of clopidogrel in Han population of Guangzhou with CHD.