Relationships of CYP2C19 gene polymorphism and serum NT-proBNP level with poor prognosis of intravenous thrombolysis in acute cerebral infarction
Objective To explore the relationships between CYP2C19 gene polymorphism,serum N-terminal B-type brain natriuretic peptide precursor(NT-proBNP)level,and poor prognosis of intravenous thrombolysis in patients with acute cerebral infarction(ACI).Methods A total of 210 patients with ACI were selected and treated with intrave-nous thrombolysis with alteplase.After 90 days of treatment,patients were divided into the poor prognosis group(mRS score≥3 points)of 52 cases and good prognosis group(mRS score<3 points)of 158 cases based on the modified Rankin Scale(mRS)score.Before treatment,real-time fluorescence quantitative PCR was used to detect CYP2C19 gene polymor-phism,and time-resolved fluorescence immunoassay was used to detect serum NT-proBNP.The correlations between CYP2C19 gene polymorphism,serum NT-proBNP level and mRS Score were analyzed by Pearson or Spearman.Multivari-ate Logistic regression was used to analyze the influencing factors for prognosis of intravenous thrombolysis in ACI patients.The predictive value of CYP2C19 gene polymorphism and serum NT-proBNP level in predicting the prognosis of intrave-nous thrombolysis in ACI patients was analyzed by receiver operating characteristic curves.Results The age,hyperten-sion ratio,diabetes ratio,National Institutes of Health Stroke(NIHSS)score at admission and fasting blood glucose level in the poor prognosis group were higher than those in the good prognosis group(all P<0.05).There was a statistically sig-nificant difference in CYP2C19 gene polymorphism between the poor prognosis group and the good prognosis group(P<0.05),and the serum NT-proBNP level in the poor prognosis group was higher than that in the good prognosis group(P<0.05).The CYP2C19 gene polymorphism(rs=0.362)and serum NT-proBNP level(r=0.426)were positively correlated with mRS score in ACI patients(both P<0.05).High NIHSS score,CYP2C19 gene slow metabolism type,and high se-rum NT-proBNP levels were risk factors for poor prognosis in ACI patients(all P<0.05).The area under the curve of CYP2C19 gene polymorphism and serum NT-proBNP levels alone and in combination for the prognosis of intravenous thrombolysis in ACI patients was 0.752,0.786,and 0.861,respectively,and the area under the curve of the combina-tion of the two was higher than that of either alone(all P<0.05).Conclusion CYP2C19 gene polymorphism and high level of NT-proBNP are risk factors for poor prognosis in ACI patients undergoing intravenous thrombolysis,and the combi-nation of the two has higher predictive value for poor prognosis.
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