Research on the Correlation between Dual Anti-platelet Therapy after Per-cutaneous Coronary Intervention and Different CYP2C19 Genotypes in Coronary Heart Disease Patients Complicated with Dyslipidemia
Objective To analyze the efficacy of dual antiplatelet therapy(DAPT)in patients with poor metabolizers(PM),intermediate metabolizers(IM)and extensive metabolizers(EM)of CYP2C19 gene after percutaneous coronary intervention(PCI)for coronary atherosclerotic heart disease(abbreviated as coronary heart disease)with dyslipidemia and its effect on clinical indicators.Methods 162 patients with coronary heart disease and dyslipidemia who received DAPT after interventional intervention admitted to Department of Cardiology of Haijiya Hospital in Shanxian from March 2021 to April 2023 were conveniently selected as the study objects.Among them,80 patients with high level of low-density lipoprotein cholesterol(LDL-C)were the observation group,and 82 patients with normal lipid were the control group.The platelet aggregation inhibition rates of the observation group and the control group were compared,and the differences in the total effective rate,the incidence of cardiovascular-related adverse events and platelet ag-gregation indexes of patients with different CYP2C19 genotypes were analyzed.Results The total effective rate of EM type,IM type and PM type was compared[91.30%(63/69),84.28%(59/70),73.91%(17/23)],and the difference was statistically significant(χ2=6.738,P<0.05).Comparison of the incidence of cardiovascular events in patients with dif-ferent CYP2C19 genotypes,the difference was statistically significant(P<0.05).There was no significant difference in platelet count between patients with different CYP2C19 genotypes(P>0.05).In the observation group and the control group,the platelet aggregation inhibition rate of EM type patients was higher than that of IM type and PM type,and the inhibition rate of IM type patients was higher than that of PM type,the differences were statistically significant(all P<0.05).Conclusion The inhibition rate of DAPT on ADP-induced platelet aggregation in patients with coronary heart disease and dyslipidemia after intervention was lower than that in patients with normal blood lipids,and the therapeu-tic effect and cardiovascular events of patients with different CYP2C19 genotypes were different.
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