Correlation between platelet glycoprotein III a gene polymorphism and the risk of vascular events in patients taking aspirin after intracranial and extracranial artery stenting： a prospective case series study

Abstract

Objective To investigate the correlation between platelet glycoprotein （GP） III a polymorphisms of rs5918, rs2317676, and rs11871251 and the occurrence of vascular events in patients long-term taking aspirin after intracranial and extracranial artery stenting. Methods The patients who successfully performed cerebral vascular stenting from December 2009 to October 2012 were enrolled respectively. The GP II a polymorphisms were analyzed by using multiple ligase detection reaction. The clinical follow-up was conducted for the patients. The primary endpoint events were ischemic stroke, vascular death, and myocardial infarction. Results A total of 433 patients whose genotyping success and the follow-up information available were enrolled. They were followed up for mean 10. 21 ±2.71 months, and 28 patients had vascular events. Genotyping showed that the minor allele frequencies （MAF） of rs5918, rs2317676, and rs11871251 were 0. 46%, 20. 67%, and 48.73%, respectively. The clinical follow-up showed that the incidence of the primary endpoint events of the carriers of rs11871251 A allele was significantly higher than that of the noncarriers （hazard ratio [ HR], 8.83, 95% confidence interval [ CI] 1.20 -65.00; P =0. 032）. Comparison of different genotypes of rs5918 and rs2317676 showed that there was no significant difference in the incidence of endpoint events （Log rank, P = 0. 608 and 0. 556, respectively）. Multivariate Cox proportional hazards model analysis showed that the rs11871251 A allele was the independent risk factor for the occurrence of endpoint events （HR 7. 878, 95% HR 1. 035 - 59. 982; P=0. 046）, and smoking was an independent protective factor for poor outcome （HR O. 327, 95% CI 0. 108 -0. 990; P = 0. 048）. Conclusions GP III a gene rs11871251 polymorphism may be a risk factor affecting patients taking aspirin after intracranial and extracranial artery stenting. Key words: Stroke; Brain Ischemia; Stents; Aspirin; Drug Resistance; Platelet Glycoprotein GP II b- IIIa Complex; Polymorphism, Genetic