Correlation between cytochrome P450 2C19 gene polymorphism and cardiovascular event after PCI in coronary heart disease / 重庆医学

ABSTRACT

Objective To investigate the correlation between cytochrome P450(CYP) 2C19 gene polymorphism with major adverse cardiovascular events(MACE) after PCI in the patients with coronary heart disease(CHD).Methods A total of 233 patients with CHD undergoing PCI in the cardiology department of our hospital from January 2014 to January 2015 were selected.All patients were given the standardized dual anti-platelet therapy of aspirin and clopidogrel.The occurrence situation of MACE within 1 year(unstable angina pectoris,cardiac death,in-stent restenosis,non-fatal myocardial infarction) was obtained by follow up.All patients were divided into the MACE group and non-MACE group.The PCR solubility curve was adopted to detect the CYP2C19 gene polymorphism.Results Among 233 cases of CHD,37 cases (15.88％) developed cardiovascular events and 196 cases (84.12 ％) did not develop vascular events;the age,sex,hypertension and diabetes mellitus had no statistical differences between the two groups(P＞0.05).The frequency of CYP2C19 * 1 in the included cases was 68.45％,which of CYP2C19 * 2 was 28.33％ and which of CYP2C19 * 3 was 3.22％.The extensive-metabolism,intermediate metabolism and slow metabolism types in the cardiovascular events group accounted for 5.41 ％,64.86 ％ and 29.73 ％ respectively,while which in the non event group were 59.69 ％,29.08％ and 11.22％ respectively,the CYP2C19 genotype distribution had statistically significant difference between the two groups(P＜0.05).The multivariate Logistic regression analysis showed that CYP2C19 intermediate metabolism type [OR 2.562,95％CI(2.825,7.350),P=0.021 0],slow metabolism type [OR 5.139,95％CI(1.289,5.232),P＜0.01],hypertension [OR 2.480,95 ％CI(1.079,5.698),P=0.032 4],smoking[OR 4.802,95％CI(1.082,18.371),P=0.029 0] were the independent risk factors for the occurrence of cardiovascular events in the patients with CHD.Conclusion CYP2C19 * 2 and CYP2C19 * 3 gene polymorphism are the independent risk factors for MACE occurrence after PCI in the patients with CHD.