Comparatively Study On The Verifynow And TEG In Monitoring Clopidogrel Effect Of Different CYP2C19 Genotype Patients

Objectives:In order to choose a better method which detection the effect of clopidogrel have specificity, stability and predictive power for slow metabolism, MACE, bleeding events to service patients, this article would be analyzed the relevance, consistency and the forecast of slow metabolism, MACE, bleeding events of Verifynow and TEG detect clopidogrel effect in patients with different CYP2C19 genotype.Methods:Choose 150 cases of PCI postoperative patients, on the basis of CYP2C19 genotype were divided into fast metabolism, intermediary metabolism and slow metabolism group, then use Verifynow and TEG detect clopidogrel effect. We would record patients’s clinical data, and follow-up the rate of MACE, bleeding events in 6 months. We would analyze the relevance and consistency of Verifynow and TEG using correlation analysis and the Kappa statistic, use the ROC curve analysis the forecast of slow metabolism, MACE, bleeding events of Verifynow and TEG detect clopidogrel effect.Results:Correlation and Kappa analysis:the test results of Verifynow and TEG were low negative correlation(|r|=0.359, P<0.05) and weaker consistency(Kappa coefficient=0.554, P<0.05)in the fast metabolism group. There is significant negative correlation (|r|=0.415, P<0.05) and weaker consistency(Kappa coefficient=0.456, P<0.05)in the intermediary metabolism group. But there is no correlation and consistency in the slow metabolism groupCP> 0.05).When predict CYP2C19 genotype was slow metabolism, the area under the ROC curve of Verifynow and TEG are 0.796(95% CI:0.704-0.889, P=0),0.359(95% CI:0.247-0.471, P=0.026), respectively. In the prediction of MACE events, the area under the ROC curve of Verifynow and TEG were 0.85(95%CI:0.716-0.985, P<0.05),0.206(0.027-0.385, P<0.05); respectively; There is no statistical significance in predicting bleeding events(P> 0.05).Conclusion:There is low negative relevance and consistency between Verifynow and TEG in the fast metabolism group, There is significant negative relevance and weaker consistency between Verifynow and TEG in the slow metabolism group, there is no relevance and consistency in the slow metabolism group. In the prediction of slow metabolism and MACE events, Verifynow is better than that of TEG. So clinicians can use Verifynow detect effect of clopidogrel priority.