GP1BA and CYP2C19 Gene Tests Adjust the Individualized Antiplatelet Therapy Strategy and Safety Evaluation of Coronary Heart Disease
To explore the adjustment of individualized antiplatelet therapy strategies for coronary heart disease through detection of GP1BA and CYP2C19 gene polymorphisms,and to evaluate the anti-platelet status and safety,a total of 191 patients with coronary heart disease receiving antiplatelet therapy in Hai'an People's Hospital from November 2021 to December 2022 were prospectively selected.GP1BA and CYP2C19 genes were detected and grouped according to the detection results and platelet inhibition rate.Individualized treatment strategies were developed according to genotyping and platelet inhibition rate,and the differences of gender,underlying diseases,age,smoking and BMI between the two groups were observed for 90 days.The platelet count,platelet inhibition rate,activation rate,adhesion rate,efficacy and the incidence of adverse events such as cardiac death,bleeding,angina pectoris,myocardial infarction and thrombosis were compared between the two groups before and after 3 months adjustment of treatment strategy.Individualized treatment strategies were developed by combining AA/ADP inhibition rate and CYP2C19 and GP1BA genotypes.Combined with the inhibition rate of AA/ADP and CYP2C19 and GP1BA genotypes,95 cases were divided into observation group:AA/ADP inhibition rate＜20％,20％～50％,50％～75％,＞95％,and 96 cases were enrolled in control group:95％＞AA/ADP inhibition rate＞75％.There were no significant differences in gender,underlying diseases(hypertension,diabetes,hyperlipidemia),age,smoking and BMI between the two groups(P＞0.05).Before adjusting the treatment strategy,the platelet count of observation group(279.47± 19.58)× 109/L was significantly higher than that of control group(198.36±12.92)× 109/L,P＜0.05;After 3 months of treat-ment,there was no significant difference in platelet count between the two groups(P＞0.05).Before adjusting the treatment strategy,the platelet inhibition rate of observation group(29.62±1.69)％was significantly lower than that of control group(51.22± 2.12)％.The platelet activation rate(66.45±3.49)％and platelet adhesion rate(84.33±6.22)％in observation group were significantly higher than those in control group(42.51±2.39)％and(62.54±4.31)％,P＜0.05.After 3 months of treatment,there were no significant differences in platelet inhibition rate,activation rate and adhesion rate between the two groups(P＞0.05).Before the adjustment of treatment strategy,the total effective rate of the observation group(64.21％)was significantly lower than that of the control group(91.67％),P＜0.05,and there was no significant difference between the two groups after the adjustment of treatment strategy,P＞0.05.There was no significant difference in the total incidence of adverse events between the observation group(5.26％)and the control group(4.17％),P＞0.05.Good results have been achieved through the development of individualized treatment strategies for the detection of GP1BA and CYP2C19 genes in patients with coronary heart disease,which has important clini-cal significance for the adjustment of individualized antiplatelet therapy strategies for coronary heart disease,and can safely and reliably adjust antiplatelet therapy strategies to avoid the occurrence of adverse cardiovascular events caused by abnormal drug dosage.
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