Influence of CYP2C19*2 gene polymorphism on MACE after PCI / 心血管康复医学杂志

ABSTRACT

Objective:To explore the impact of cytochrome P450 oxidase (CYP2C19) *2 genotype on major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) and impact of MACE on blood stasis indexes .Methods:From Jan 2010 to Jan 2011 ,a total of 355 patients with blood stasis syndrome undergoing PCI were enrolled .All patients took aspirin and clopidogrel conventionally before PCI ,then maintained for one year at least after PCI .According to MACE or not ,patients were divided into MACE group (n=64) and no MACE group (n=291) .Turbidimetry method was used to measure platelet aggregation rate before and one week after PCI ,and polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP ) was used to test CYP2C19 * 2 gene polymorphism .Results:(1) Compared with no MACE group ,there were significant rise in maximum platelet aggregation rate [MPA ,(36.38 ± 14.57)% vs .(44.87 ± 11.63)% ] and residue platelet aggregation rate [RPA , (25.76 ± 12.69)% vs .(34.45 ± 15.58)% ] , P65 years ,CYP2C19*2 gene mutation (GA+AA) ,renal dysfunction (creatinine>1.5mg/dl) and re-duced left ventricular ejection fraction (LVEF< 50% ) were independent risk factors for MACE after PCI (OR=2.164~5.947 , P<0.05 or <0.01);(3) Binary linear correlation analysis indicated that CYP 2C19*2 gene muta-tion was positively correlated with RPA after PCI ( r=0.437 , P<0.001) .Conclusion:CYP2C19*2 gene mutation affects antiplatelet activity of clopidogrel ,so it′s helps to recognize MACE risk in patients with coronary heart dis-ease and blood stasis after PCI .