|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|
|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|
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.
|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
|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.|