ADP-induced Platelet Aggregation Rate And CYP2C19 Gene Polymorphism After Clopidogrel Loading

Objective:To evaluate the platelet aggregation rate induced by adenosine diphosphate(ADP)and CYP2C19 polymorphism in acute coronary syndrome(ACS)patients scheduled to undergo Coronary angiography(CAG)/stent implantation with loading of Clopidogrel.Methods:A total of 99 participants are ACS patients that underwent CAG(±stent implantation)in Beijing Anzhen Hospital from October 2014 to January 2015.Each patient was given the loading dose of 300 mg Clopidogrel prior to operation and Clopidogrel 75 mg per day and Aspirin 100 mg per day afterwards for antiplatelet therapy.The platelet aggregation rate induced by ADP of the patients before and after taking Clopidogrel was tested.Those with the maximum platelet aggregation rate(MPAR)reducing more than 50% are classified to Normal;while 20-50% Moderate;the rest(?20%)Low.The CYP2C19 polymorphism of all the participants was tested as well to analyze the relevance of it to antiplatelet therapy with loading Clopidogrel.Additionally,the influence of gender,age,physical condition of the patients is taken into consideration.Results:In accordance with the classification mentioned above,25(25.2%)of the patients are grouped to Normal,58(58.6%)to Moderate and 16(16.2%)to Low.The research concerning the CYP2C19 polymorphism indicates that genotype is evidently relevant to reduction of the platelet aggregation rate induced by ADP in antiplatelet therapy with loading Clopidogrel(?2 =42.994,P<0.001).The study shows that the following elements including gender,hypertension,diabetes,hyperlipemia,smoking and proton pump inhibitors are not evidently relevant to antiplatelet therapy with loading Clopidogrel(P>0.05).Conclusion:The study provides evidence showing that the CYP2C19 polymorphism is relevant to ACS patients' antiplatelet therapy with loading Clopidogrel.