The clinical significance and cost effectiveness analysis of the CYP2C19 detect application in antiplatelet therapy for patients with high-risk PCI

doi:10.3969/j.issn.1672-5301.2017.12.008

Abstract：Objective Based on high-risk PCI postoperative patients to evaluate the curative effect of antiplatelet therapy,compares empirical therapy with gene detection guide individualized treatment effect and cost effective.Methods A total of 132 cases of patients who were diagnosed with high-risk PCI,and were randomized divided into control group and experimental group according to the results of the coronary angiography.Control group was empirically given Aspirin and Ticagrelor antiplatelet therapy.According to the testing results of CYP2C19 gene polymorphisms,experimental group was divided into the experimental group A given in combination with Clopidogrel regular dose of Aspirin antiplatelet therapy (38 cases),and the experimental group B given Aspirin and Ticagrelor antiplatelet therapy (32 cases).All patients with PCI postoperative 1 month,3 months,6 months and 12 months were subjected to follow-up by outpatient care or telephone.The incidence of adverse cardiovascular events,the effect of antiplatelet therapy and antiplatelet therapy cost during 1 year were compared.Results The general situation of the high-risk PCI patients between the three groups were no statistical difference (P＞0.05) and the incidence of MACE events with the effect of antiplatelet therapy among the three groups had no statistical difference (P＞0.05).Compared control group with experimental group A,the cost of postoperative antiplatelet treatment increased obviously.Conclusion In the case of high-risk patients,empirical antiplatelet therpay can increase the economic burden of patients in a certain extent.Detection of CYP2C19 gene polymorphism may have certain guiding significance for optimizing antiplatelet therapy and improving the cost effectiveness.