Li Hui, Li Miao-Nan, Kang Pin-Fang, Li Yang, Tang Yang, Lu Dong-Yu, Shi Xiao-Jun, Wang Hong-Ju
Department of Cardiology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China. E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2016 Feb 20;37(2):261-265. doi: 10.3969/j.issn.1673-4254.2017.02.20.
To investigate the relationship between plasma cytochrome P450 3A4 (CYP3A4) 894C>T gene polymorphism and the risk of recurrence of adverse cardiac events after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS).
A total of 275 patients with ACS received standard dual antiplatelet therapy and PCI. Platelet aggregation rate (PAR) was detected in each patient before and 7 days after administration of the anti-platelet drugs. Single nucleotide polymorphism of CYP3A4 gene 894C>T was detected with PCR and microarray technique. The number of coronary artery lesions was determined by PCI and the Gensini score was calculated. The patients were followed up for 3-12 months after discharge.
No significant difference was found in CYP3A4 gene polymorphism between patients with clopidogrel resistance (CR group) and those without CR (NCR group) (P>0.05). Multivariate logistic regression analysis showed that CYP3A4 gene 894C>T polymorphism was not correlated with CR in patients with ACS (OR 1.359, P>0.05). During the follow-up, the incidence of cardiovascular events was significantly higher in CR group than in NCR group (P<0.05), but this difference was not related to the mutation type of 894C>T locus of CYP3A4 gene.
The CYP3A4 gene 894C>T polymorphism is not associated with the effect of anti-platelet therapy and the risk of cardiovascular event in patients with ACS following PCI.
探讨血浆细胞色素P450 3A4（CYP3A4）894C>T基因多态性与急性冠状动脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）后不良心脏事件复发风险之间的关系。
275例ACS患者接受标准双联抗血小板治疗及PCI。在每位患者服用抗血小板药物前及服药7天后检测血小板聚集率（PAR）。采用聚合酶链反应（PCR）和基因芯片技术检测CYP3A4基因894C>T的单核苷酸多态性。通过PCI确定冠状动脉病变数量并计算Gensini评分。患者出院后随访3 - 12个月。
氯吡格雷抵抗患者（CR组）与无氯吡格雷抵抗患者（NCR组）的CYP3A4基因多态性无显著差异（P>0.05）。多因素逻辑回归分析显示，ACS患者中CYP3A4基因894C>T多态性与氯吡格雷抵抗无关（比值比1.359，P>0.05）。随访期间，CR组心血管事件发生率显著高于NCR组（P<0.05），但这种差异与CYP3A4基因894C>T位点的突变类型无关。
CYP3A4基因894C>T多态性与ACS患者PCI术后抗血小板治疗效果及心血管事件风险无关。
