Role of CYP2C19 gene polymorphism in guidance of anti-platelet therapy after PCI / 心血管康复医学杂志

ABSTRACT

Objective:To explore guidance effect of CYP2C19 gene polymorphism on anti-platelet therapy after per-cutaneous coronary intervention (PCI).Methods:A total of 105 patients with coronary heart disease,who received clopidogrel after PCI,were selected.According to results of CYP2C19 gene polymorphism detection,they were di-vided into normal metabolism group (n=51,fast metabolism type)and poor metabolism group (n=54,medium and slow metabolism type).Platelet inhibition rate induced by adenyl diphosphoric acid (ADP)measured by throm-boelastogram (TEG)and clopidogrel resistance (CR)rate were analyzed and compared between two groups.Re-sultsNormal metabolism group and poor metabolism group occupied 48.57% and 51.43% respectively among the 105 patients (medium metabolism type and slow metabolism type occupied 43.81% and 7.62% respectively in poor metabolism group).Compared with normal metabolism group,there was significant reduction in platelet inhibition rate induced by ADP [(78.14 ± 17.86)% vs.(41.67 ± 12.05 )%] and significant rise in incidence rate of CR (11.76% vs.59.26%)in poor metabolism group,P =0.001 all.Conclusion:CYP2C19 gene polymorphism is an important influencing factor for clopidogrel resistance.Therapeutic effect of clopidogrel after PCI in normal metab-olism group is significantly better than that of poor metabolism group,therefore,CYP2C19 gene polymorphism de-tection is help to guide anti-platelet therapy after PCI.