Multivariate analysis of the correlation between the gene ploymorphisms of CYP2C19 and clopidogrel’ s resistance in Han nationality acute ischemic stroke patients
LIU Zhiqin
REN Jingjing
ZHANG Weiping
DU Jingjing
JIA Xiaotao
WANG Xinlai
Abstract：Objective To analyze the relationship between CYP 2C19 gene polymorphism and clopidogrel resistance in acute ischemic stroke patients .Methods From July 2012 to September 2014 , 72 consecutive patients with acute ischemic stroke (75 mg/d, continuous >7 d) who were hospitalized and treated with clopidogrel .According to the inhibition rate of platelet aggregation induced by ADP , they were divided into clopidogrel resistance (CR) group (27 cases) and non-resistant (NCR) group (45 cases).Gene chip method was used to detect the CYP 2C19 genotype of the subjects .According to the type of mutations, the gene chip was divided into fast metabolic type (*1/*1), intermediate metabolism (*1/*2,*1/*3) and slow metabolism (*2/*2,*2/*3,*3/*3).The risk factors associated with the occurrence of clopidogrel resistance were analyzed by multiple Logistic regression analysis .Results The CYP2C19 genotype distribution were statistically signifi-cant different between the two groups (χ2 =32.302, P <0.05);detected CYP2C19 genotypes were slow metabolism in 7 ca-ses (9.7%), intermediate metabolic genotype 39 cases (54.2%), fast metabolism type in 26 cases (36.1%), 3 groups of platelet aggregation inhibition rate respectively were (67.5 ±21.6)%, (57.6 ±23.4)%and (31.4 ±15.1)%, slow metab-olism type >intermediate metabolizers >metabotropic ( P <0.01).Multivariate logistic regression analysis showed that CYP2C19 slow metabolizers (*2 /*2,*2/*3) (OR=7.802, 95%CI 1.412 to 40.304, P =0.018) and low density lipid protein levels >2.6 mmol /L (OR=3.923, 95%CI 1.314 to 17.927, P =0.032) was independent risk factors for clopidogrel resistance .Conclusion In patients with acute ischemic stroke , CYP2C19 (*2/*2,*2/*3) and low density lipoprotein levels were the independent risk factors for clopidogrel resistance .
Keywords：CYP2C19 gene polymorphismClopidogrelResistanceMultivariate analysis
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1013-1016 )