Correlation Between CYP2C19 Genotype And Platelet Aggregation Rates Detected By Light Transmittance Aggregometry In Patients With Coronary Heart Disease

Objective: To investigate the correlation between CYP2C19 genotype and platelet aggregation rates detected by light transmittance aggregometry in patients with coronary heart disease.Methods: We collected patients who were enrolled from February 2016 to February 2017 and diagnosed with coronary heart disease in the fifth department of the Second Hospital of Hebei Medical University.Patients did not receive any antiplatelet therapy before admission.All patients received300 mg clopidogrel and aspirin,then they accepted 100 mg aspirin and 75 mg clopidogrel everyday.Platelet aggregation rate was measured at admission and3 days later.All patients’ CYP2C19 genotype were detected by fluorescence in situ hybridization.According to CYP2C19 genotype test results and the dominant enzyme,patients were divided into three metabolic type: normal metabolic type(RM,*1/*1),slow metabolic type(PM,*2/*2,*2/*3,*3/*3),intermediate metabolic type(IM,*1/ *1/*3,*17/*2,*17/*3).Platelet aggregation rate was measured by light transmittance aggregometry.Patients in high-reacted group were defined that both rates in different times were more than 50 %,while in normal reacted group were defined that the second rate was less than 50%.Recording the below data,including age,body mass index(BMI),platelet count,hemoglobin count,left ventricular ejection fraction,diabetes,hypertension,dyslipidemia,smoking,PPI using history and so on.All data was analyzed by SPSS 21.0 software.Binary logistic regression analysis was used to assess the correlation between drug reaction and metabolic genotypes.Define P<0.05 as statistical significant.Results:1 There were 46 cases enrolled in this study.Among them,there were 15 female patients(32.6%),31 male cases(67.4%).The average age was 58.8±9.5 years old.There were 21 patients smoking(45.6%),33 cases with hypertension(71.7%),18 cases with diabetes mellitus(39.1%),25 cases with dyslipidemia(54.3%).All patients accepted genotype detection,there were 22 cases with normal metabolic type(47.8%),15 cases with intermediate metabolic type(32.6%)and 9 cases with slow metabolic type(19.5%).According to the drug reaction,there were 33 cases with normal drug reaction(71.7%)and 13 cases with high reaction(28.3%).2 At admission,platelet aggregation rate in normal,intermediate and slow metabolic type group was 86.4±6.7%,87.9±4.8% and 89.8±3.2%separetely,without statistical significance(P>0.05).After three days,the rates were 34.8±8.2%,45.4±5.8% and 64.0±5.5%.There was no difference in the latter numbers(P<0.05).3 After three days of clopidogrel treatment,indicators including age,BMI,platelet count,hemoglobin count,left ventricular ejection fraction(LVEF),diabetes mellitus,hypertension,dyslipidemia,smoking,PPI drug using and so on were without statistical significance in groups with different drug reactions(All P<0.05).4 Among three types of genotype,there was a significant difference in patient numbers with various drug reaction in three genotype(P < 0.05).Binary logistic regression analysis showed there was a specific correlation between drug reaction and metabolic genotypes(P=0.01,OR=10.096)。.Conclusion:There is a certain correlation between platelet aggregation rate detected by light transmittance aggregometry and CYP2C19 genotype.