关键词: CYP2C19, 基因多态性, PCI, 个体化用药

Abstract:

AIM: To investigate the genetic polymorphism of CYP2C19 among patients requiring percutaneous coronary intervention（PCI）, and to determine the anticoagulation therapy according to genotypes so as to observe its clinical efficacy. METHODS: CYP2C19 variants were detected by PCR-RFLP method in patients requiring PCI. The extensive metabolism（EM）group was treated with clopidogrel with loading dose of 300 mg at the first time and 75 mg/d for 12 months.While the intermediate metabolism (IM) group was treated with clopidogrel with loading dose of 300 mg at the first time and 150 mg/d for 12 months.The poor metabolism (PM) group was treated with ticagrelor with loading dose of 180 mg at the first time and 90 mg,bid for 12 months.All three groups were given Aspirin of 100 mg/d. During the follow-up of 12 months,the incidence rates of major adverse cardiac events （MACE） in the three groups were observed and compared. RESULTS: Five genotypes of CYP2C19 were found in these subjects,and that the frequency of EM was 37.6%,IM 55.6% and PM 6.8%.No significant difference related to the incidence rates of major adverse cardiac events in the three groups during the follow-up of 12 months was observed. CONCLUSION: CYP2C19 genotype can instruct the medication of anticoagulation therapy; patients with fast metabolism can receive regular dose of clopidogrel, while patients with mutation should consider larger dose of clopidogrel or other anticoagulation drugs.

Key words: CYP2C19, genotype polymorphism, PCI, individualized therapy