The association of genetic polymorphism with clopidogrel resistance among patients after percutaneous coronary intervention

Abstract

Objects To investigate the correlation of the single nucleotide polymorphism (SNP) of clopidogrel related gene CYP2C19, ABCB1, PON1 to the occurrence of clopidogrel resistance (CR) and TEG among patients after percutaneous coronary intervention. Methods A total of 299 patients after PCI were enrolled from April 2015 to December 2015.It genotyped the CYP2C19(rs4244285, rs4986893)ABCB1(rs1045642) and PON1(rs662) gene, measured clopidogrel response by TEG. Accordingly, all the enrolled 299 patients were then divided into CR group (n=17) + non-CR (NCR) group (n=282) or CLR group (n=54) + non-CR (NCR) group (n=245) by TEG(%). All the patients were divided into EM、IM and PM group by CYP2C19 genotype. The age of patient in CR (71.1±11.1) years old is higher than NCR (65.02±10.51) years old (t=2.559, P<0.05). Results CYP2C19 PM was associated with decreased of TEG(ADP) (Z=-2.065, P=0.039), while it was not related to the age of patient(Z=0.405, P>0.05). There was no significant difference between CR(χ2=0.175, P=0.916) CLR(χ2=1.589, P=0.452)and the level of TEG(ADP) (Z=-0.030, P=0.976) in PON1(rs662) polymorphism. There was no significant difference between CR(χ2=1.722, P=0.423) CLR(χ2=0.176, P=0.916)and the level of TEG(ADP) (Z=-0.331, P=0.741) in ABCB1(rs1045642) polymorphism. Conclusions CYP2C19 PM is associated with decreased of TEG(ADP). It is considered that no correlation exists between ABCB1(rs1045642) and PON1(rs662) polymorphism and clopidogrel resistance in patients with coronary heart diseases. The loss of function of ABCB1(rs1045642) and PON1(rs662) is not associated with decreased of TEG(ADP) in CYP2C19 PM patients.(Chin J Lab Med, 2016, 39: 678-684) Key words: Ticlopidine; Aromatase; Aryldialkylphosphatase; P-Glycoproteins; Polymorphism, single nucleotide; Platelet aggregation