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学科主题临床医学
CYP2C19*2 and Other Allelic Variants Affecting Platelet Response to Clopidogrel Tested by Thrombelastography in Patients with Acute Coronary Syndrome
Liu, Jian1; Nie, Xiao-Yan2; Zhang, Yong1; Lu, Yun3; Shi, Lu-Wen2; Wang, Wei-Min1
关键词Acute Coronary Syndrome Clopidogrel Resistance Cyp2c19 Polymorphisms Platelet Reactivity Thrombelastography
刊名CHINESE MEDICAL JOURNAL
2015-08-20
DOI10.4103/0366-6999.162515
128期:16页:2183-2188
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Medicine, General & Internal
研究领域[WOS]General & Internal Medicine
关键词[WOS]ANTIPLATELET THERAPY ; MYOCARDIAL-INFARCTION ; STENT IMPLANTATION ; ARTERY-DISEASE ; RISK-FACTORS ; INTERVENTION ; REACTIVITY ; POLYMORPHISMS ; ASSOCIATION ; VARIABILITY
英文摘要

Background: To investigate the contributions of CYP2C19 polymorphisms to the various clopidogrel responses tested by thrombelastography (TEG) in Chinese patients with the acute coronary syndrome (ACS).

Methods: Patients were screened prospectively with ACS diagnose and were treated with clopidogrel and aspirin dual antiplatelet therapy. CYP2C19 loss of function (LOF) and gain of function (GOF) genotype, adenosine 5′-diphosphate (ADP)-channel platelet inhibition rate (PIR) tested by TEG and the occurrence of 3-month major adverse cardiovascular events and ischemic events were assessed in 116 patients.

Results: High on-treatment platelet reactivity (HTPR) prevalence defined by PIR <30% by TEG in ADP-channel was 32.76% (38/116). With respect to the normal wild type, CYP2C19*2, and *3 LOF alleles, and *17 GOF alleles, patients were classified into three metabolism phenotypes: 41.38% were extensive metabolizers (EMs), 56.90% were intermediate metabolizers (IMs), and 1.72% were poor metabolizers (PMs). Of the enrolled patients, 31.47%, 5.17%, and 0.43%, respectively, were carriers of *2, *3, and *17 alleles. The HTPR incidence differed significantly according to CYP2C19 genotypes, accounting for 18.75%, 41.54%, and 100.00% in EMs, IMs, and PMs, respectively. Eighteen (17.24%) ischemic events occurred during the 3-month follow-up, and there was a significant difference in ischemic events between HTPR group and nonhigh on-treatment platelet reactivity group.

Conclusions: Genetic CYP2C19 polymorphisms are relative to the inferior, the antiplatelet activity after clopidogrel admission and may increase the incidence of ischemic events in patients with ACS.

语种英语
WOS记录号WOS:000360138900009
引用统计
被引频次:5[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/50627
专题北京大学第二临床医学院_心血管内科
北京大学药学院_药事管理与临床药学系
作者单位1.Hennepin Cty Med Ctr, Dept Pharm, Minneapolis, MN 55415 USA
2.Peking Univ, Peoples Hosp, Dept Cardiol, Beijing 100044, Peoples R China
3.Peking Univ, Hlth Sci Ctr, Sch Pharmaceut Sci, Beijing 100191, Peoples R China
推荐引用方式
GB/T 7714
Liu, Jian,Nie, Xiao-Yan,Zhang, Yong,et al. CYP2C19*2 and Other Allelic Variants Affecting Platelet Response to Clopidogrel Tested by Thrombelastography in Patients with Acute Coronary Syndrome[J]. CHINESE MEDICAL JOURNAL,2015,128(16):2183-2188.
APA Liu, Jian,Nie, Xiao-Yan,Zhang, Yong,Lu, Yun,Shi, Lu-Wen,&Wang, Wei-Min.(2015).CYP2C19*2 and Other Allelic Variants Affecting Platelet Response to Clopidogrel Tested by Thrombelastography in Patients with Acute Coronary Syndrome.CHINESE MEDICAL JOURNAL,128(16),2183-2188.
MLA Liu, Jian,et al."CYP2C19*2 and Other Allelic Variants Affecting Platelet Response to Clopidogrel Tested by Thrombelastography in Patients with Acute Coronary Syndrome".CHINESE MEDICAL JOURNAL 128.16(2015):2183-2188.
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