Influence Of CYP2C19 Gene Polymorphism On The Prognosis Of Patients With Coronary Artery Disease After Percutaneous Coronary Intervention

Objectives:In the current study,we explored CYP2C19 genotype distribution in patients with coronary artery disease,and the relationship between CYP2C19 polymorphism and prognosis,to provide reference for dual anti-platelet treatment after percutaneous coronary intervention(PCI).Materials and Methods:We collected 219 patients diagnosed with coronary heart disease who received PCI from January 2015 to June 2016 in our hospital.Patients accepted the CYP2C19 gene detection and were divided into three groups according to the results.There are 84 patients with rapid metabolism(CYP2C19*1/*1),106 patients with middle metabolism(CYP2C19*1/*2,CYP2C19*1/*3)and 29 patients with slow metabolism(CYP2C19*2/*2,CYP2C19*2/*3,CYP2C19*3/*3).Dual antiplatelet therapy(DAPT)was administered to all patients.During a period(at least six months)of fellow up after PCI,the incidences of death,acute myocardial infarction,stroke,unscheduled repeated revascularization,bleeding,and platelet aggregation rate were recorded and analyzed by SPSS 22.0 software.Results:In the 84 patients with rapid metabolic type,there was no patient with unscheduled repeated revascularization,7 patients in 106 patients with middle metabolism,and 3 patients in 29 patients with slow metabolic type,the difference was statistically significant(P = 0.027).There was no difference in platelet aggregation rate among the three groups before DAPT.However,but the difference was statistically significant after 6 months of dual antiplatelet therapy(P<0.001).There was no difference among three groups in death,acute myocardial infarction,stroke and bleeding(P>0.05).Conclusion:Patients with CYP2C19 slow metabolism were less effective to anti-platelet treatment than those with rapid metabolism,and they also had a high incidence of unscheduled repeated revascularization after PCI.The CYP2C19 gene polymorphism might be one of the influences on the prognosis of patients with coronary artery disease after PCI.