中国急性缺血性卒中患者中的CYP2C19多态性与氯吡格雷抗血小板效应

Department of Neurology, Drum Tower Hospital of Nanjing Medical University, 321 ZhongShan Rd, Nanjing City, Jiangsu Province, 210008, China

Background and Purpose-Little research regarding genotypes and clopidogrel response related to acute ischemic stroke has been published. This study was conducted to investigate whether the polymorphisms of receptors or enzymes involved in the metabolic process of clopidogrel affect clopidogrel response and prognosis related to acute stroke. Methods-A total of 259 patients with acute ischemic stroke were enrolled in this study; all received follow-up evaluations 3 and 6 months after clopidogrel treatment. CYP2C19, CYP3A4, and P2Y12 were screened. The adenosine diphosphateinduced platelet aggregation test, the National Institutes of Health Stroke Scale (NIHSS), and the modified Rankin Scale (mRS) were used, and blood vascular events were evaluated. Results-The difference before and after clopidogrel treatment on adenosine diphosphate-induced platelet aggregation was significantly smaller in patients carrying 1 or 2 CYP2C19 loss-of-function alleles (*2,*3) compared with patients carrying none. Patients with none had better outcomes than patients with CYP2C19 loss-of-function alleles, as demonstrated by NIHSS and mRS scores at 3 and 6 months after treatment. Regression analysis showed that CYP2C19 was an independent predictor of clopidogrel resistance. Conclusions-CYP2C19 genotypes had significant impact on clopidogrel response and prognosis of patients with stroke. © 2013 American Heart Association, Inc.

Xu, Y.; Department of Neurology, Drum Tower Hospital of Nanjing Medical University, 321 ZhongShan Rd, Nanjing City, Jiangsu Province, 210008, China;