Relationship Between CYP2C19 Gene Polymorphism And Antiplatelet Effect In Patients With Slow Metabolism After PCI

Objective: To investigate the distribution characteristics of cytochrome P450 2C19(CYP2 C19)genotypes in different ethnic groups in Xinjiang,and two antiplatelet treatment regimens in patients with CYP2C19 slow metabolizing type after percutaneous coronary intervention(PCI)(byaspirin combined with clopidogrel high maintenance dose)maintenance,aspirin combined with ticagrelor)clinical prognosis differences.Methods:(1)1908 patients with coronary heart disease(CHD)were enrolled,and CYP2C19 gene was detected to analyze the distribution characteristics of CYP2C19 genotypes and metabolites in Uygur,Kazak,Hui and Han patients with CHD;(2)223 patients with CHD slow metabolizing PCI were randomly divided into clopidogrel high maintenance dose maintenance group(n=117)and ticagrelor group(n=106).Two major cardiovascular adverse events(MACE)were observed within 1 year,bleeding events and adverse drug reactions..Results:(1)There were significant differences in the distribution of CYP2C19 metabolites and genotypes among Uygur,Kazak,Hui and Han patients with CHD;(2)The target vascular stenosis and dyspnea rates in the two groups of patients with slow metastatic CHD were 13.67% and 3.77%,0.85% and 10.37%,respectively(P<0.05).The difference was statistically significant;death,re-PCI,acute myocardium The incidence of infarction and hemorrhagic events were 0.85% and 0.94%,2.56% and 3.77%,2.56% and 1.89%,3.42% and 6.60%(P>0.05),and the difference was not statistically significant.Conclusion: The distribution characteristics of CYP2C19 genotypes in different ethnic groups in Xinjiang were different(P<0.05).Compared with high-dose clopidogrel,ticagrelor significantly reduced the incidence of MACE after PCI in patients with slow metabolism and increased the proportion of dyspnea.However,the bleeding risk was similar between the two groups.