Relationship between MACE occurrence and CYP2C19 gene polymorphism in patients with coronary heart disease after PCI treatment with clopidogrel
Wang Jing
Li Binbin
Xu Min
Zhang Yumei
Zhou Dan
He Wei
Zha Guizhen
Liu Xuechun
Abstract：Objective To explore the relationship between the occurrence of major adverse cardiovascular events(MACE)after clopidogrel treatment in patients with coronary heart disease(CHD)following percutaneous coronary intervention(PCI)and the cytochrome P450 2C19(CYP2C19)gene polymorphism,aiming to provide a reference for clinical treatment.Methods This study included 111 patients with CHD who underwent PCI and were treated with clopidogrel and aspirin for 6 months af-ter surgery,admitted to the 901st Hospital of the Joint Logistics Support Force of the People's Liberation Army between Janu-ary 2022 and June 2024.Based on whether MACE occurred within 6 months of treatment,the patients were assigned to the MACE group(n=23)and the non-MACE group(n=88).General data were collected on the first day on admission,including sex,age,cardiac function classification,number of coronary artery stents,and left ventricular ejection fraction.CYP2C19 gen-otyping was determined using polymerase chain reaction(PCR).Multivariate logistic regression analysis was conducted to i-dentify factors influencing MACE occurrence after clopidogrel treatment in CHD patients.Results Among the CHD patients,37(33.33%)had the fast metabolizer CYP2C19 genotype,63(56.76%)had the intermediate metabolizer genotype,and 11(9.91%)had the slow metabolizer genotype.The distribution of CYP2C19 genotypes and metabolic phenotypes between the MACE and non-MACE groups showed statistically significant differences(P<0.05).Multivariate logistic regression analysis showed that the CYP2C19 *2/*2 genotype(OR=5.573,95%CI:1.593-19.500),CYP2C19 *2/*3 genotype(OR=1.774,95%CI:1.051-2.993),and CYP2C19 slow metabolizer phenotype(OR=4.889,95%CI:2.386-10.018)were in-dependent risk factors for MACE occurrence after clopidogrel treatment(P<0.05).Conclusion CYP2C19 gene polymor-phism is closely correlated with the occurrence of MACE in CHD patients treated with clopidogrel.Slow metabolizers are more prone to clopidogrel resistance and have a higher risk of MACE occurrence.Clinically,the use of clopidogrel should be avoided in these patients.
Keywords：Coronary heart diseaseClopidogrelCYP2C19Major adverse cardiovascular eventsGene polymorphism
Publication Date：2025-10-20
Online Publishing Date：2026-01-15(First online date of this platform, not the publication date of the document)
Pages：7( 75-81 )