Yuan Huai Wu, Huang Xia, Pan Min Ying, Chen Xuan Yu, Hu Yun Zhen, Lin Mei Hua, Wang Jian Er, Wu Yong, Hu Jun, Cao Mei Ling, Liang Hui
Department of neurology, The first affiliated hospital of Zhejiang university, Hang-Zhou, China.
Department of neurology, People's Hospital of Pu-Jiang county, Jin-Hua, China.
Pharmacogenomics. 2025 Jan-Feb;26(1-2):31-37. doi: 10.1080/14622416.2025.2478810. Epub 2025 Mar 31.
We aimed to identify the impact of CYP2C19 polymorphism testing on clinical outcomes in patients who have undergone carotid artery stenting (CAS).
This was a single-center retrospective cohort study. CYP2C19 polymorphisms were identified based on the presence of two normal functional alleles in normal metabolizers (NMs), a normal functional allele and a nonfunctional allele in intermediate metabolizers and two nonfunctional alleles in poor metabolizers. Patients were recommended for the CYP2C19 polymorphism testing followed by the change in dual antithrombotic drugs (DAPT) at the discretion of the supervising physician. The primary clinical endpoint was stent thrombosis (ST). Logistic regression was used to evaluate the relative risk of clinical outcomes.
A total of 273 patients were included. The relative risk of ST was not reduced in patients who underwent CYP2C19 polymorphism testing than in patients without this test (3.1% vs. 3.9%, OR = 0.914, 95% CI = 0.218-3.841). The ST in NMs and non-NMs was 3.4% and 2.9%, respectively, and showing no reduction in NMs (OR = 1.145, 95% CI = 0.162-8.105). Changing DAPT did not reduce the relative risk of ST compared with non-changing (2.3% vs. 3.2%, OR = 1.604, 95% CI = 0.024-107.033).
CYP2C19 polymorphism was not related to stent thrombosis in patients with CAS.
我们旨在确定CYP2C19基因多态性检测对接受颈动脉支架置入术（CAS）患者临床结局的影响。
这是一项单中心回顾性队列研究。根据正常代谢者（NMs）中两个正常功能等位基因的存在情况、中间代谢者中一个正常功能等位基因和一个无功能等位基因以及慢代谢者中两个无功能等位基因来确定CYP2C19基因多态性。患者被建议进行CYP2C19基因多态性检测，随后由主管医生酌情改变双联抗血栓药物（DAPT）。主要临床终点是支架血栓形成（ST）。采用逻辑回归评估临床结局的相对风险。
共纳入273例患者。接受CYP2C19基因多态性检测的患者发生ST的相对风险并不低于未进行此项检测的患者（3.1%对3.9%，OR = 0.914，95%CI = 0.218 - 3.841）。NMs和非NMs的ST发生率分别为3.4%和2.9%，NMs中ST发生率未降低（OR = 1.145，95%CI = 0.162 - 8.105）。与未改变DAPT相比，改变DAPT并未降低ST的相对风险（2.3%对3.2%，OR = 1.604，95%CI = 0.024 - 107.033）。
CAS患者中CYP2C19基因多态性与支架血栓形成无关。
