Early Screening and Precise Treatment of Clopidogrel Resistance Based on CYP2C19 Gene Polymorphism / 医药导报

ABSTRACT

Objective To screen patients with clopidogrel resistance and develop accurate anti-platelet therapy strategies based on CYP2C19 gene polymorphism.Methods A total of 200 patients with acute coronary syndrome/percutaneous coronary angioplasty were selected.The pyrophosphate sequencing technology was using to detect CYP2C19 gene polymorphism for identifying clopidogrel poor metabolizers and guide antiplatelet therapy according to the development of clopidogrel resistance strategies.Results The proportion of patients with clopidogrel resistance (including intermediate metabolizers and slow metabolizers) was about 63.5%.In clopidogrel intermediate metabolizers, 41.4% cases were applied double dosages of clopidogrel and about 20.2% patients were given ticagrelor instead of clopidogrel.For clopidogrel slow metabolizers, approximately 39.3% cases were given doubled dosage of clopidogrel and 46.4% cases were given ticagrelor.Compared with previous data, the proportion of individual treatment of clopidogrel resistance was significantly increased in this study.Conclusion The strategies for the treatment of clopidogrel resistance, which based on the polymorphism of CYP2C19 gene, have been achieved initial success.