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Influence of CYP2C19 gene polymorphisms on the efficacy of clopidogrel treatment for the prevention of ischemic stroke following coronary stent implantation / 中华医学遗传学杂志
Chinese Journal of Medical Genetics ; (6): 839-843, 2017.
Article in Chinese | WPRIM | ID: wpr-344164
ABSTRACT
<p><b>OBJECTIVE</b>To assess the association of CYP2C19 gene polymorphisms with the incidence of ischemic stroke among patients receiving clopidogrel therapy following coronary stenting for coronary artery disease.</p><p><b>METHODS</b>Clinical data of patients receiving clopidogrel therapy after coronary stenting were retrospectively studied. For a case-control study, 137 patients with acute cerebral infarction and 122 non-stroke patients were selected. Based on the variants of the CYP2C19 gene detected by a DNA microarray assay, the patients were further divided into the wild-type group(CYP2C19*1/*1) and mutant group(defined by the presence of at least one loss-of-function allele, including CYP2C19*1/*2, CYP2C19*1/*3, CYP2C19*2/*2, CYP2C19*2/*3 and CYP2C19*3/*3). The incidences of ischemic stroke in the two groups were compared through a chi-square analysis. The influence of CYP2C19 gene polymorphisms and clopidogrel therapy on the incidence of ischemic stroke was analyzed through multivariable logistic regression.</p><p><b>RESULTS</b>A total of 259 patients were enrolled. The case and control groups showed no difference in terms of gender and age. There were 123 cases (47.5%) in the CYP2C19 wild-type group and 136 cases (52.5%) in the mutant group. The incidence of ischemic stroke of mutant group was significantly higher than that of wild-type group (59.9% vs. 44.3%, X2=6.398, P=0.042). Multivariate analysis revealed that loss-of-function polymorphisms of the CYP2C19 gene carried a 1.13 times greater risk for ischemic stroke compared to wild-type genotype (OR=2.13, 95%CI 1.23-3.71).</p><p><b>CONCLUSION</b>The efficacy of clopidogrel for the prevention of ischemic stroke in post-coronary stent patients may be reduced by the insufficiency of the CYP2C19 gene. The dosage of clopidogrel therapy should be adjusted based on its polymorphisms.</p>
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: Polymorphism, Genetic / Ticlopidine / Platelet Aggregation Inhibitors / Stents / Brain Ischemia / Stroke / Therapeutic Uses / Percutaneous Coronary Intervention / Cytochrome P-450 CYP2C19 / Genetics Type of study: Observational study / Risk factors Limits: Humans Language: Chinese Journal: Chinese Journal of Medical Genetics Year: 2017 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Polymorphism, Genetic / Ticlopidine / Platelet Aggregation Inhibitors / Stents / Brain Ischemia / Stroke / Therapeutic Uses / Percutaneous Coronary Intervention / Cytochrome P-450 CYP2C19 / Genetics Type of study: Observational study / Risk factors Limits: Humans Language: Chinese Journal: Chinese Journal of Medical Genetics Year: 2017 Type: Article