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CYP2C19 gene polymorphism is associated with clopidogrel metabolism in human body. Clopidogrel is often used in patients of acute myocardial infarction as one of dual antiplatelet therapy. The objective was to investigate the distribution of CYP2C19 gene polymorphism and the correlation with platelet function in patients with acute myocardial infarction.
The retrospective study included the 950 patients with acute myocardial infarction enrolled in the Department of Cardiology of General Hospital of Shenyang Military Region between December 2012 to January 2012 who received CYP2C19 gene detection. All patients received standard dual antiplatelet therapy (Aspirin 100mg, qd+clopidogrel 75mg, qd). CYP2C19 gene chip detector was produced by Beijing BAIAOXIN technology company. The genetic polymorphisms of CYP2C19*2 and *3 were evaluated by 3ml venous blood sample. The study analyzed the distribution of CYP2C19 gene polymorphism the correlation with common clinical characteristics in patients with acute myocardial infarction.
In 950 patients with acute myocardial infarction, 643 patients with acute ST segment elevation myocardial infarction, 307 patients with acute non ST segment elevation myocardial infarction.388 Cases (40.8%) were CYP2C19 gene wild type (*1/*1), 483 cases (50.8%) were heterozygous type (*1/*2 or *1/3), 79 case (8.4%) were the homozygous mutation type (*2/*2 or *2/*3 or *3/*3). In clinical data, there were no significant differences in sex, hypertension, diabetes, previous myocardial infarction, the type of myocardial infarction. During the hospitalization period, the proportion of high platelet reactivity (ADP>60%) was 57% (45 cases) in the CYP2C19 gene homozygous mutation type, 41% (198 cases) in the CYP2C19 gene heterozygous type and 34% (132 cases) in the CYP2C19 gene wild type. There was no significant difference in the incidence of high platelet reactivity between heterozygous and wild type (p=0.783) and there was statistically different in homozygous mutation type respectively compared with heterozygous type and wild type (p=0.013, 95% CI:1.78-5.17; P<0.001,95%CI:2.32-5.88).
CYP2C19 gene homozygous mutation (*2/*2 or *2/*3 or *3/*3) may be associated with high platelet reactivity, while the CYP2C19 wild type (*1/*1) and mutant heterozygous (*1/*2 or *1/3) were not found to be associated with high platelet reactivity in the observed 950 patients with acute myocardial infarction treated with dual antiplatelet therapy.