Individualized use of clopidogrel based on CYP2C19 genotype / 中国药学杂志

ABSTRACT

OBJECTIVE: To explore the impact of CYP2C19 genotype on major adverse cardiac events (MACE) in coronary disease patients receiving clopidogrel treatment, and provide reference for rational use of clopidogrel in clinic. METHODS: Coronary disease patients hospitalized in the Vasculocardiology Department of our hospital from Apr to Sep 2014 were enrolled, CYP2C19 genotype was detected by pyrosequencing method, and the MACE caused by clopidogrel treatment was studied. RESULTS: Among the 174 enrolled cases, CYP2C19*2 and CYP2C19*3 mutant alleles were observed in 96 patients (55.17%). Compared with patients with wild type, the mutant alleles carriers had higher risk of MACE (47.92% vs 11.54%, P<0.05). Compared with clopidogrel monotherapy, combined antiplatelet therapy with clopidogrel and aspirin lowered the risk of MACE (35.84% vs 62.79%, P<0.05). CONCLUSION: It is suggested that CYP2C19*2 and CYP2C19*3 mutant alleles carriers receive higher dosage of clopidogrel, or use combined antiplatelet therapy or other antiplatelet drugs.