Relationship between polymorphism of cytochrome P450 2C19 and clinical response to clopidogrel / 中国综合临床

ABSTRACT

Objective To discuss the relationships of the genotype of cytochrome P450 2C19 (CYP2C19) gene and and clopidogrel responsiveness.Methods The study enrolled 110 patients with acute myocardial infarction who were treated with clopidogrel in Tiantan Hospital of Beijing from November 2012 to May 2014.Patients were treated by aspirin and clopidogrel.CYP2C19 polymorphisms were detected by genotype testing kits.Platelet inhibition rates were measured by thrombelastography to represent the antiplatelet effect of clopidogrel.The platelet inhibition rates of clopidogrel were compared among different genotypes.Results Compared with carriers of CYP2C19 * 2 or * 3 reduced-function allele,CYP2C19 * 1 wild type had higher platelet inhibition rate of clopidogrel ((35.73 ± 19.29)％ vs.(48.30± 20.84)％),and the difference was significant(t =3.264,P＜0.05).There was no difference between intermediate metabolizer((35.72± 19.27)％) and poor metabolizer((35.75±19.89)％;P＞0.05).The frequency of wild-type homozygotes CYP2C19 * 1/* 1 was higher in responders than in low responders(frequency of low reaction group CYP2C19 * 1/* 1 14 cases (40.0％),* 1/.2 10 cases(28.6％),* 1/* 3 4 cases(11.4％),* 2/* 2 5 cases(14.3％),* 2/* 3 2 cases (5.7％),frequency of reaction group were 45 cases (60.0％),15 cases (20.0％),4 cases (5.3 ％),7 cases (9.3％),4 cases(5.3％);x2 =3.838,P =0.05).Conclusion Polymorphism of gene CYP2C19 is associated with different responses to clopidogrel.CYP2C19 * 2/ * 3 reduced-function allele is associated with low response to clopidogrel.