Relationship Between The Recurrence Of Ischemic Stroke In One Year After Taking Clopidogrel And The Gene Polymorphisms In Ischemic Stroke Patients

Objective: It is reported that recurrence of cerebral infarction in long-term taking clopidogrel patients with cerebral infarction is related to CYP2C19 gene polymorphisms.Some studies have also shown that it is associated with polymorphisms of ABC B1 C3435 T and PON1 G576 A genes.However,CYP2C19,ABC B1 C3435 T,PON1 G576 A gene polymorphisms in clopidogrel treatment of cerebral infarction patients with in 1 year of recurrent cerebral infarction is relatively small,This study aimed to investigate the relationship between the recurrence of cerebral infarction in one year taking clopidogrel patients with non-cardiogenic cerebral infarction and CYP2C19,ABC B1 C3435 T and PON1 G576 A polymorphisms.Methods: Using the self-control case study,CYP2C19,ABC B1 C3435 T and PON1 G576 A genotypes were analyzed by non-amplified fluorescent in situ hybridization("Beijing Precision Medical Platform" analysis software),183 patients detected all genotypes,The latest definition of non-cardiogenic cerebral infarction proposed by the American Stroke Association,patients given 30 d of clopidogrel plus aspirin treatment at first,then only clopidogrel treatment,informed consent was informed before treatment,the clinical datas were recorded and followed up for 1 year,They were divided into recurrent cerebral infarction group and non-recurrent cerebral infarction group according to whether the ischemic stroke recurred or not.Results: In this study,220 patients were initially enrolled in the study,13 with hemorrhagic tendency,8 with other severe physical diseases,and 16 patients were not able to complete 1 year follow-up.A total of 183 patients with non-cardiogenic cerebral infarction were enrolled in the study.Recurrent cerebral infarction group was 43 cases,and non-recurrent cerebral infarction group was 140 cases,suggesting that the incidence of recurrence in this issue was 23.5%,There were no significant differences in sex,age,smoking,hypertension,diabetes,blood lipids between the two groups(all P > 0.05).The number of EM patients in recurrent cerebral infarction group(16.3%)was significantly lower than that in non-recurrent cerebral infarction group(37.9%)(P < 0.05),while the number of PM patients in recurrent cerebral infarction group(27.9%)was significantly higher than that in non-recurrent cerebral infarction group(11.4%)(P < 0.05).The IM(55.8%)in recurrent cerebral infarction group was higher than that in non-recurrent cerebral infarction group(45.7%),but there was no significant difference between the two groups(P> 0.05).The genotypes of ABCB1 3435C> T gene showed no significant difference between the two groups in CC genotype,CT genotype and TT genotype(P> 0.05).There was no significant difference between the two genotypes of wild type(GG),mutant heterozygous(GA)and homozygous mutant(AA)of PON1 G576 A gene(P> 0.05).Conclusion: There was lower risk of cerebral infarction resulting from cerebral infarction for patients in one year with EM type of C YP2C19 gene.Patients with PM type of CYP2C19 gene were more likely to suffer from cerebral infraction.The recurrence of stroke in long-term taking clopidogrel patients after the first attack of cerebral infarction was associated with the mutation of C YP2C19 gene.Routine CYP2C19 testing may be warranted.