The Primary Investigation Of The Association Between CYP2C19Polymorphisms Involved In Clopidogrel Metabolism And Clinical Efficacy On Secondary Stroke Prevention In Fujian Han Population

Objective To investigate the frequency of CYP2C19polymorphisms involved inclopidogrel metabolism in Fujian Han population and influence of CYP2C19genepolymorphisms on the clinical efficacy of clopidogrel on ischemic cerebral infarctionsecondary prevention. Method We detected the frequency of CYP2C19*2,CYP2C19*3and CYP2C19*17in1001unrelated Fujian Han volunteers bypolymerase chain reaction-restriction fragment length polymorphism and directsequencing method,and retrospective follow-up visit523ischemic cerebral infarctionpatients from November2009to October2010,selected the patients takingclopidogrel over1year and then assessed the relation between CYP2C19*2,*3,*17and clinical efficacy of clopidogrel.Result The frequencies of CYP2C19*2,*3and*17were32.4%,5.8%and0.4%respectively. According to metabolizergenotyping, intermediate metabolizers (*1/*2and*1/*3) and poor metabolizers(*2/*2and*2/*3),carrying CYP2C19*2or*3,accounted for47.95%and13.99%. Our data were similar to the report of Japan, Korea, Singapore, Malaysia,Thailand, Chinese Dai、Mongolian、LI and Hui(P>0.05) but were different from thatof Chinese KazaKh、Uygur, Iran, Russia, Italy, Poland, Norway, Canada, nativeIndians, Bolivia, Egypt, Tanzania (P <0.05).During the follow-up period,68patientscontinued treatment with clopidogrel and stroke in14patients among them. Due tomeet the requirements of cases rarely, now only preliminary estimates that it is notstatistical significance that CYP2C19gene polymorphism influence clopidogrelmetabolism and efficacy. Conclusion Ethnic/regional diversity exist in prevalence of CYP2C19polymorphisms. Our data show no significant difference in the frequencyof CYP2C19polymorphisms when compared with Dai、Mongolian、Li and Hui inChina, parts of the population in East and Southeast Asia,and have a higher frequencyof intermediate metabolizers and poor metabolizers than that in the populationanalyzed of KazaKh and Uygur in China, Europe, South America and Afric（aP<0.05）.Preliminary estimates that it is not significant relationship between CYP2C19genepolymorphism and clopidogrel metabolism and efficacy.