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Effect of clopidogrel gene on platelet reactivity and major cardiovascular events in patients with acute coronary syndrome

Yanli Li, Xiaoye Li, Can Chen, Wen Pan, Xiaoyu Li, Qianzhou Lv

Article ID: 1916
Vol 4, Issue 1, 2023

DOI: https://doi.org/10.54517/ccr.v4i1.1916
VIEWS - 49 (Abstract)

Abstract

Objective To investigate the effect of clopidogrel gene polymorphism on platelet reactivity and major cardiovascular events in patients with acute coronary syndrome (ACS). Methods 149 patients with ACS who underwent percutaneous coronary intervention (PCI) in Zhongshan Hospital Affiliated to Fudan University from January to December 2019 were included. All patients were tested for clopidogrel related genotypes after admission. Aspirin (100mg/d) and clopidogrel (75mg/d) were taken regularly after operation, and the inhibition rate of platelet aggregation (IPA) induced by adenosine diphosphate (ADP) was detected. According to the IPA results, the patients were divided into two groups: high platelet reactivity (HPR) group after clopidogrel treatment (IPA<30%) and low platelet reactivity (LPR) group after clopidogrel treatment (IPA>30%). Results: according to IPA results, there were 23 cases (15.44%) in HRP group and 126 cases (84.56%) in LRP group. The IPA induced by arachidonic acid (AA) in HRP group was significantly lower than that in LPR group (P <005). There were significant differences in CYP2C19*2, CYP2C19* 3, ABCB1 AND PON1Q192R loss of function (LOF) alleles between the two groups (p<005). Multivariate logistic regression analysis showed that CYP2C19 * 2DF allele was associated with mace after PCI (or= 3112, 95% С I 1048~9241, P = 0041). Conclusion: clopidogrel gene polymorphism has certain effect on platelet reactivity in patients with ACS. CYP2C19 * 2 gene mutation is related to mace after PCI.

Keywords

acute coronary syndrome; clopidogrel; gene polymorphism; platelet reactivity; major adverse cardiovascular events

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