To Investigate The Value Of CYP2C19 Gene Polymorphism In The Treatment Of Platelet Therapy In Patients After PCI

Objective: To investigate The guiding value of CYP2C19 gene polymorphism in anti-platelet therapy for patients after PCIMethods: A total of 333 patients who underwent PCI in our hospital from 2017 to2018 were enrolled in the study.The CYP2C19 genotyping results were grouped,including the poor metabolome(56 cases)and the middle metabolome(150 cases).Fast metabolome(127 patients),three groups of patients were treated with clopidogrel antiplatelet therapy after PCI;The rate of platelet aggregation inhibition-(IPA)and the incidence of adverse cardiovascular events during treatment were compared and analyzed at 1,3 and 6 months.Results:There were no statistical differences in IPA values between the three groups before treatment(P>0.05).After drugs treatment for 1,3 and 6 months,the IPA of the poor metabolome group and middle metabolome group were significantly lower than that of the fast metabolome group and which existed statistical difference(P<0.05);however,there was no significant statistical difference between in the poor metabolome group and the middle metabolome group at 1,3 and 6 months after treatment and which was no statistical difference(P>0.05).After 6 months of medication,the incidence of Major Adverse Cardiovascular Events(MACE)in the poor metabolome group and middle metabolome group were significantly higher than that of the fast metabolome group and there was statistical difference(P<0.05);the incidence of Major Adverse Cardiovascular Events(MACE)there was no significant statistical difference between in the poor metabolome group and the middle metabolome group after 6 months of medication and there was no statistical difference(P>0.05).Conclusion: For PCI postoperative coronary disease patients should be regular cyp2p19 genetic testing,than according to the test results we can obtain the accurate antiplatelet therapy.If conventional dose clopidogrel is blindly given for antiplatelet therapy,some patients will develop clopidogrel resistance,which cannot effectively prevent the occurrence of adverse cardiovascular events.Routine doses of clopidogrel can be used for antiplatelet therapy for fast metabolizers,while adjustment of treatment regimen is required for slow and moderate metabolizers;the ultimate goal is reduce the incidence of Major Adverse Cardiovascular Events(MACE)and improve prognosis.