The Relationgship Between Cyp2c19*2Genetic Mutations And Coronary Heart Disease And Clopidogrel Resistance

Objectives Research on the relationship between CYP2C19*2gene polymorphismand clopidogrel resistance in patients with coronary heart disease and coronary heartdisease.Methods144cases of coronary heart disease patients were continuously selected fromJuly2013to March2014in the coal Cardiology Hospital. Record all the basic clinicaldatum of the patients: including age, gender, smoking history, history of hypertension,diabetes, coronary heart disease (unstable angina, acute ST-segment elevation myocardialinfarction, non-ST segment elevation acute myocardial infarction), old myocardialinfarction, coronary angiography or coronary CTA results, biochemical indicators. Allthe patients were detecting genetic polymorphism of CYP2C19*2. All the patients canbe divided into three groups (AA group, AG group, GG group) according to the differentgenotype.1To analysis of the distribution proportion of the patients in the three groups.2Analysis of differences in the three groups of patients in age, male, PCI, and OMIprevious medical history.3To analysis of the distribution proportion in the three groupsof patients about combining with hypertension and diabetes.4Analyze the extent of thethree groups of patients with CHD (UAP, STEMI, NSTEMI, and interventional treatment)situation.541patients were used fluorescence turbid metric method to measure plateletaggregation rate and then Comparing the difference between the groups of patientsplatelet aggregation rate.625cases of patients were tested ADP inhibition rate by TEF,of which20patients were defined as clopidogrel resistant patients (ADP inhibition rate≤50%), analysis of the difference in CR patients about coronary heart disease illness andPCI therapy. The results were analyzed using SPASS17.0software.Results The cases and percentage of the three groups are respectively of16cases(11.10%),53cases (36.80%),75cases (52.10%).2There have no statistical difference inage and previous medical history of PCI and OMI in the three group of patients. Theratio of male in GG group is higher than in AG group, and the difference was statisticallysignificant (P<0.05).3Three groups of patients with hypertension rates are:81.25%,81.13%,65.33%.4Three groups of patients with diabetes rates are:37.5%,33.96%,26.67%.5Three groups of patients with concomitant diabetes rates are:25%,30.19%, 18.67%.6There have no statistical difference in the three groups of patients (unstableangina, non-ST segment elevation myocardial infarction, ST-segment elevationmyocardial infarction and undergoing PCI treatment).7The platelet aggregation of thethree groups of patients respectively are48.5±13.46(%),49.1±17.80(%),49.1±17.80(%).8There has on statistical difference in clopidogrel resistance about coronary heartdisease (CHD) condition (UAP, STEMI and NSTEMI)(P<0.05). The cases of AG groupare more than in GG group, and the difference has statistically significant (P<0.05).Conclusion1The proportion of CYP2C19*2mutant(AA、AG) is47.9%in thisexperimental group.2The patients who used conventional of clopidogrel in mutantgroup have obsivously higher platelet aggregation than that in pure group.3Theproportion of the PCI therapy is obviously higher in mutant group than that of pure groupin CR patients.