The clinical characteristics of clopidogrel related gene polymorphism in patients after percutaneous coronary intervention
Objective To discuss the clinical characteristics of clopidogrel related genes[Cytochrome P4502C19(CYP2C19),ATP-binding cassette subfamily B member 1(ABCB1)and paraoxonase 1(PON1)]in patients after percutaneous coronary intervention(PCI).Methods 318 patients who underwent PCI were enrolled.They were treated with clopidogrel combined with aspirin,and five gene locus,CYP2C19*2,CYP2C19*3,CYP2C19*17,ABCB1 and PON1,were detected by fluorescence staining in situ hybridizationThe clopidogrel-resistant and clopidogrel-normal groups were screened by thromboelastography at 1 month postoperatively,and the occurrence of CYP2C19 related genes was compared.All patients were followed up for 6 months,and the bleeding status of the patients was recorded,and the occurrence of CYP2C19 related genes was compared.Results Clopidogrel related genotypes of 318 patients after PCI were as follows:10.06%of AA mutant and 30.81%of AG heterozygous in CYP2C19*2 gene;no mutant and 30.81%of AG heterozygous in CYP2C19*3 gene;no mutant and 6.29%of CT heterozygous in CYP2C19*17 gene;ABCB1 gene mutant accounted for about 9.74%,CT heterozygous for 52.52%;10.06%of AA mutant and 65.41%of AG heterozygous in PON1 gene.The incidence of two loss-of-function(LOF)alleles in the clopidogrel-resistant group was greater than that in the clopidogrel-normal group(P<0.05).Most of the 28 bleeding cases carried gain-of-function(GOF)alleles.Conclusion From the genotype of patients after PCI,heterozygous and mutant types of clopidogrel-related genes are common,the absorption and metabolism of clopidogrel in these patients will be partly affected.The risk of coronary thrombosis is higher,while the risk of bleeding is lower.So it should be paid attention in clinic,especially for patients with acute coronary syndrome.
Percutaneous coronary interventionClopidogrelGene polymorphismFluorescence staining in situ hybridization
NETL
NSTL
万方数据
维普
