Xiao Fei-Yan, Liu Min, Chen Bi-Lian, Cao Shan, Fan Lan, Liu Zhao-Qian, Zhou Hong-Hao, Zhang Wei, Zhou Gan
Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008; Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China.
Department of Cardiovascular, Zhengzhou Central Hospital, Zhengzhou University, Zhengzhou 450007, PR China.
Gene. 2017 Aug 5;623:63-71. doi: 10.1016/j.gene.2017.04.029. Epub 2017 Apr 22.
Dual antiplatelet therapy is the gold standard for the clinical treatment of coronary artery disease, especially for acute coronary syndromes patients. However, a substantial number of patients do not respond to clopidogrel despite a standardized dosage regimen, and this is directly associated with poor prognosis. Genetic polymorphisms may be one of the most important factors that contribute to this phenomenon. In this study, we aimed to detect new single nucleotide polymorphisms that can influence the efficacy of clopidogrel in 851 acute coronary syndromes (ACS) patients. Four outcomes (cerebrovascular event, Acute Myocardium Infarction, unstable angina and death) were used as endpoints among three cohorts (northern, central and southern China) of acute coronary syndromes patients. Three SNPs (rs2244923, rs2773341 and rs34428341) were significantly associated with at least one outcome in all subjects. One SNP rs16863352, may play a role in predicting unstable angina in acute coronary syndrome patients ≥75years of age.
双联抗血小板治疗是冠心病临床治疗的金标准，尤其适用于急性冠脉综合征患者。然而，尽管采用了标准化给药方案，仍有相当数量的患者对氯吡格雷无反应，这直接与不良预后相关。基因多态性可能是导致这一现象的最重要因素之一。在本研究中，我们旨在检测851例急性冠脉综合征（ACS）患者中可能影响氯吡格雷疗效的新单核苷酸多态性。在急性冠脉综合征患者的三个队列（中国北方、中部和南方）中，将四个结局（脑血管事件、急性心肌梗死、不稳定型心绞痛和死亡）用作终点。三个单核苷酸多态性（rs2244923、rs2773341和rs34428341）在所有受试者中均与至少一个结局显著相关。一个单核苷酸多态性rs16863352可能在预测≥75岁急性冠脉综合征患者的不稳定型心绞痛中起作用。
