Correlation between clopidogrel low responsiveness and CYP2C19 gene polymorphism in patients with coronary heart disease
Hu Chengyan
Li Jing
Liu Zhi
Abstract：study the correlation between clopidogrel low responsiveness (CLR) and CYP2C19 gene polymorphism in CYP450 enzyme in patients with coronary heart disease (CHD). Methods CHD patients (n=680) were chosen from Department of Cardiology in Xuanwu Hospital affiliated to Capital University of Medical Sciences from Mar. 2015 to Sept. 2018. All patients were divided, according to whether or not adenosine diphosphate (ADP)-induced platelet inhibition rate below 30% detected by using thrombelastogram (TEG), into CLR group and non-CLR group (NCLR group). At the same time, the genotypes of CYP2C19 were detected, and divided, according to genotypes of CYP2C19, into fast metabolism type (CYP2C19*1*1), moderate metabolism type (CYP2C19*1*2, CYP2C19*1*3) and slow metabolism type (CYP2C19*2*2, CYP2C19*2*3, CYP2C19*3*3). The relationship between CLR and genotypes of CYP2C19 was analyzed. Results ①Among 680 patients, there were 304 (44.7%) in CLR group and 376 (55.3%) in NCLR group. The general data including age, body mass index (BMI), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), hypertension and diabetes had no statistical difference (P>0.05), and sex, smoking history, drinking history, platelet count, glutamic oxalacetic transaminase (GOT) and triglyceride (TG) had statistical difference (P<0.05) in 2 groups. ②The difference in CYP2C19 gene polymorphism had statistical significance between 2 groups (P<0.05). ③The difference in CLR had statistical significance among 3 genotypes of CYP2C19 (P<0.05). The comparisons among fast metabolism type, moderate metabolism type and slow metabolism type had statistical significance (P<0.05), and difference between moderate metabolism type and slow metabolism type had no statistical significance (P=0.063). ④The results of multi-factor Logistic regression analysis showed that platelet count, GOT and CYP2C19 gene polymorphism had correlation (P<0.05). ⑤Based on ROC analysis, the detection of genotypes of CYP2C19 had predictive effect on clopidogrel responsiveness. Conclusion CLR is correlated to CYP2C19gene polymorphism in CHD patients, and detection of CYP2C19 gene polymorphism has a guiding significance to clinical application of antiplatelet drugs.
Keywords：Gene polymorphismthrombelastogramPlatelet inhibition rateClopidogrel low responsiveness
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1375-1379,1383 )