Correlation between CYP2C19 polymorphism and risk stratification of acute coronary syndrome

LIU Li-xia; XUE Jian; ZHANG Xiao-zhong; CHEN Jian-kui; ZHANG Jun-jun

doi:10.3969/j.issn.1674-4055.2016.12.17

Abstract：Objective To discuss the relationship between CYP2C19 polymorphism and risk stratification of acute coronary syndrome (ACS).Methods ACS patients (n=158, male 66 and female 92) were chosen from the Affiliated Hospital of Academy of Military Medical Sciences from Jan. 2015 to Sept. 2015. All patients were divided into fast-metabolism group (n=77), medium-metabolism group (n=61) and slow-metabolism group (n=20) according to the detective results of CYP2C19 genotypes. The patients were given risk stratification by using GRACE scoring and divided into low-risk group (0-108,n=89), mid-risk group (109-140,n=40) and high-risk group (>140,n=29). The relationship between CYP2C19 genotypes and high-risk factors of ACS was analyzed.Results The level of brain natriuretic peptide (BNP) was significantly higher in high-risk group than that in low-risk group and mid-risk group (allP<0.05). The percentage of slow-metabolism cases increased significantly in high-risk group compared with low-risk group and mid-risk group (allP<0.05). GRACE scores were (104±32) in fast-metabolism group, (112±31) in medium-metabolism group and (138±56) in slow-metabolism group, which were significantly higher in slow-metabolism group then those in medium-metabolism group and fast-metabolism group (allP<0.05). The results of multiple Logistic regression analysis showed that the change of CYP2C19 slow-metabolism genotype (OR=13.336, 95%CI: 3.195~55.661,P<0.001) and higher BNP level (OR=2.147, 95%CI: 1.457-5.539,P=0.026) were high-risk factors in ACS patients.Conclusion CYP2C19 slow-metabolism genotype is a high-risk factor in ACS patients, and it is very important for reviewing ACS risk to definite genotypes.