<p>Impacts of <em>CYP2C19</em> Polymorphism and Clopidogrel Dosing on in-Stent Restenosis: A Retrospective Cohort Study in Chinese Patients</p>

氯吡格雷 医学 再狭窄 加药 CYP2C19型 回顾性队列研究 支架 内科学 队列 阿司匹林 新陈代谢 细胞色素P450
作者
Min Zhang,Jiangrong Wang,Yong Zhang,Pei Zhang,Zhisheng Jia,Manyi Ren,Xiaomeng Jia,Liping Ma,Mei Gao,Yinglong Hou
出处
期刊:Drug Design Development and Therapy [Dove Medical Press]
卷期号:Volume 14: 669-676 被引量:6
标识
DOI:10.2147/dddt.s242167
摘要

Objective: This retrospective cohort study is to analyze the impacts of CYP2C19 polymorphism and clopidogrel dosing on in-stent restenosis (ISR) after coronary stenting. Methods: Totally, 111 patients were included, who underwent percutaneous coronary intervention (PCI) with drug-eluting stent. Patients received clopidogrel treatment after the intervention on the background treatment with aspirin, based on the genotypes: 75 mg clopidogrel once each day for subjects without CYP2C19 loss-of-function (LOF) alleles (n=51; EM), 75 mg clopidogrel once each day (n=27; IM75) or twice each day (n=33; IM150) for subjects with one CYP2C19 LOF allele. ISR at 3– 18 months after coronary stenting was assessed. Results: ISR rate was significantly higher in the IM75 group (40.7%) than the EM group (11.8%). ISR rate in the IM150 group was lower than the IM75 group (6.1% vs 40.7%), and comparable to that in the EM group. Multivariate logistic regression showed that both CYP2C19 genotype and clopidogrel dosing were associated with the risk of ISR after adjusting the relevant confounding factors. ISR risk was higher in the IM patients than the EM patients. Patients with clopidogrel dose of 75 mg once each day had significantly higher risk of ISR than those with the dose of 75 mg twice each day. Conclusion: Increased dose of clopidogrel may reduce the risk of ISR after PCI in CYP2C19 LOF allele(s) carriers. The presence of CYP2C19 LOF allele(s) increases the risk of ISR after stenting, which could be counteracted by the increased dose of clopidogrel. Keywords: CYP2C19 polymorphism, in-stent restenosis, ISR, clopidogrel, percutaneous coronary intervention, PCI
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