Abstract:

Objective To study the distribution characteristic of CYP2C19 gene polymorphism in coronary heart disease （CHD）patients in northern Fujian,to evaluate the clinical prognosis of different anti-platelet （PLT） drug therapies after percutaneous coronary intervention（PCI）,and to provide a reference for anti-PLT aggregation treatment. Methods A total of 520 patients diagnosed as CHD by coronary angiography undergoing PCI were enrolled and followed up. CYP2C19 genotype was determined. All patients should be in drug-eluting stents（DES）. According to genotypes combined with coronary artery disease severity,the patients were classified into 3 groups（fast,intermediate and slow metabolic types）. The distribution of genotypes was assessed. After PCI for 1,6 and 12 months,the occurrence of major adverse cardiovascular events （MACE） was recorded. Results There were 224 （43.07%） cases of CYP2C19 homozygous fast metabolic type. There were 227 （43.65%） cases of intermediate metabolic type,including 186 （82%） cases of 681 base function locus mutation. There were 69 （13.26%） cases of slow metabolic type. After 1-year follow-up,there was no statistical significance for MACE occurrence among the 3 groups （P>0.05）. Conclusions CYP2C19 loss-of-function （LOF） increases in patients with CHD in northern Fujian. Through genotype determination,selecting different anti-PLT aggregation drugs or adjusting anti-PLT aggregation drug doses,the occurrence of MACE can decrease,which can improve long-term prognosis in CHD patients.

Key words: CYP2C19 gene polymorphism, Coronary heart disease, Anti-platelet drug, Major adverse cardiovascular event