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伊朗接受经皮冠状动脉介入治疗患者中ABCB1基因多态性与氯吡格雷反应性的关联

Association of ABCB1 Gene Polymorphisms and Clopidogrel Responsiveness in Iranian Patients undergoing Percutaneous Coronary Intervention.

作者信息

Namazi Soha, Sahebi Ebrahim, Azarpira Negar, Rostami-Yalmeh Javad, Kojuri Javad, Khalili Andia

机构信息

Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

Department of Pharmacotherapy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Iran J Pharm Res. 2020 Spring;19(2):307-316. doi: 10.22037/ijpr.2020.1101083.

Abstract

Clopidogrel is an antiplatelet agent currently used for preventing stent thrombosis. Despite certain clinical benefits of clopidogrel in patients undergoing percutaneous coronary intervention (PCI), adequate antiplatelet effect has not been obtained in some patients. The present study was designed to investigate the potential association of ABCB1 (ATP-Binding Cassette, Subfamily B, member1) gene polymorphism, and clopidogrel responsiveness in Iranian patients after PCI. Sixty-seven patients were included in the study. Blood samples were taken from patients at baseline, 2 h after administration of 600-mg loading dose of clopidogrel, 24 h and 30 days after PCI. Platelet aggregation was measured by light transmittance aggregometry (LTA) with two levels of adenosine diphosphate (ADP) concentrations (5 and 20 µM). ABCB1 genotyping was performed by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). The allelic frequencies of wild type, heterozygote, and homozygote genotypes of ABCB1 were 20.9%, 74.6%, and 4.5%, respectively. There was no significant association between polymorphism of ABCB1 and clopidogrel non-responsiveness ( > 0.05) in various situations. No significant difference was observed for demographic characteristics. Genetic and demographic factors had no significant effect on the platelet activity of clopidogrel in an Iranian population.

摘要

氯吡格雷是一种目前用于预防支架血栓形成的抗血小板药物。尽管氯吡格雷在接受经皮冠状动脉介入治疗(PCI)的患者中具有一定的临床益处,但在一些患者中尚未获得足够的抗血小板效果。本研究旨在调查伊朗PCI术后患者ABCB1(ATP结合盒转运体B亚家族成员1)基因多态性与氯吡格雷反应性之间的潜在关联。67名患者纳入研究。在基线、给予600mg负荷剂量氯吡格雷后2小时、PCI术后24小时和30天采集患者血样。采用透光率比浊法(LTA)在两种二磷酸腺苷(ADP)浓度水平(5和20µM)下测量血小板聚集。通过限制性片段长度多态性-聚合酶链反应(RFLP-PCR)进行ABCB1基因分型。ABCB1野生型、杂合子和纯合子基因型的等位基因频率分别为20.9%、74.6%和4.5%。在各种情况下,ABCB1多态性与氯吡格雷无反应性之间均无显著关联(P>0.05)。人口统计学特征无显著差异。在伊朗人群中,遗传和人口统计学因素对氯吡格雷的血小板活性无显著影响。

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