Jin Hui, Song Jinfei, Shen Xiaoying, Liang Qing, Sun Guangchun, Yu Yan
Department of Pharmacy, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, 200240, China.
Pharmacogenomics. 2023 Mar;24(4):227-237. doi: 10.2217/pgs-2022-0167. Epub 2023 Mar 9.
The effect of multiple mutations in , and genes on the effectiveness and safety of dual antiplatelet therapy after percutaneous coronary intervention remains unclear. In total, 263 Chinese Han patients were enrolled in this study. Platelet aggregation rates and thrombosis risk were used to compare clopidogrel responses and outcomes in patients with different numbers of genetic mutations. Our study demonstrated that 74% of the patients carried more than two genetic mutations. High platelet aggregation rates were associated with genetic mutations in patients receiving clopidogrel and aspirin after percutaneous coronary intervention. Genetic mutations were closely related to the recurrence of thrombotic events, but not bleeding. The number of genes that become dysfunctional in patients is directly correlated with the risk of recurrent thrombosis. Compared with alone or the platelet aggregation rate, it is more helpful to predict clinical outcomes by considering the polymorphisms of all three genes.
α、β和γ基因的多重突变对经皮冠状动脉介入治疗后双联抗血小板治疗的有效性和安全性的影响尚不清楚。本研究共纳入263例中国汉族患者。采用血小板聚集率和血栓形成风险来比较不同基因突变数量患者的氯吡格雷反应和预后。我们的研究表明，74%的患者携带两种以上基因突变。经皮冠状动脉介入治疗后接受氯吡格雷和阿司匹林治疗的患者中，高血小板聚集率与基因突变有关。基因突变与血栓形成事件的复发密切相关，但与出血无关。患者中功能失调的基因数量与复发性血栓形成风险直接相关。与单独使用氯吡格雷或血小板聚集率相比，考虑所有三个基因的多态性对预测临床结局更有帮助。
