Correlation between clopidogrel responsiveness and CYP2C19 gene polymorphism after PCI

Zhang Haibo; Zheng Xianjie

doi:10.3969/j.issn.1674-4055.2018.11.15

Abstract：Objective To observe the correlation between clopidogrel responsiveness and CYP2C19 gene polymorphism in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Methods CHD patients (n=164) undergone PCI were chosen from Department of Cardiovascular Medicine of the First Affiliated Hospital of Henan University from Aug. 2015 to Aug. 2017. The patients were, according to platelet inhibition rate, into normal clopidogrel response group (NCLR group, n=102) and clopidogrel low-response group (CLR group, n=62). The basic data was compared between 2 groups. CYP2C19 gene polymorphism was determined by using DNA microarray chip method, and genotype distribution features and influencing factors of CLR were compared. Results The cholesterol level was significantly lower (P<0.05), and percentages of patients with BMI>25 kg/m2 and type 2 diabetes mellitus (T2DM) were significantly higher (P<0.05) in CLR group than those in NCLR group. The percentages of genotypes G/G, G/A and A/A at CYP2C19*2 site accounted for, respectively, 48.78%, 38.41% and 12.81%, and frequency of alleles G and A was, respectively, 68.29% and 31.71% in 164 patients. The percentages of genotypes G/G, G/A and A/A at CYP2C19*3 site accounted for, respectively, 93.90%, 2.44% and 3.66%, and frequency of alleles G and A was, respectively, 95.43% and 4.57%. The frequency of genotypes G/A and A/A and allele A at CYP2C19*2 site was significantly higher in CLR group than those in NCLR group (P<0.05), and that of genotype G/G and allele G had no statistical significance between 2 groups (P>0.05). The frequency of all genotypes and all alleles at CYP2C19*3 site had no statistical significance between 2 groups (P>0.05). The results of Cox regression analysis showed that gene mutation at CYP2C19*2 site, BMI>25 kg/m2and T2DM were independent influencing factors of CLR (P<0.05) in CHD patients undergone PCI. Conclusion The gene mutation at CYP2C19*2 site, BMI>25 kg/m2and T2DM are independent risk factors of CLR CHD patients after PCI.