Relationship between clopidogrel-related polymorphisms and variable platelet reactivity at 1 year: A cohort study from Han Chinese

Background: this study was designed to investigate the effect of clopidogrel‑related gene polymorphisms on platelet reactivity and clinical outcome in chinese han patients. materials and methods: three hundred and thirty‑six percutaneous coronary intervention ‑ treated patients were recruited and followed for 1 year. blood samples were collected from all patients for dna genotyping. the platelet reactivity unit was measured by the verifynow technique. the cyp2c19*2,cyp2c19*3,cyp2c19*17,atp‑binding cassette subfamily b member 1,itgb3,cyp2c9*3,cyp2b6*9,and p2y12 alleles were assessed. results: the clinical endpoints were related to previous heart disease history (11.90% vs. 28.57%,p = 0.017),stroke (12.24% vs. 16.67%,p = 0.039),and diabetes (27.55% vs. 52.38%,p = 0.047). high on‑treatment platelet reactivity (htpr) was frequent in advanced age (p = 0.019),male gender (p = 0.016),hypertension (p = 0.033),and chronic renal failure (p = 0.040). there were more endpoints in the cyp2c19*2 and p2y12 mutant carriers (76.19% vs. 43.20%,p < 0.001; 50.00% vs. 35.71%,p = 0.001,respectively),whereas fewer in the cyp2c19*17 mutant carriers (11.90% vs. 56.46%,p = 0.001). cyp2c19*2 and p2y12 polymorphism manifested htpr (194.25 ± 45.91 vs. 151.38 ± 58.14,p < 0.001; 180.33 ± 67.25 vs. 161.89 ± 56.49,p = 0.008,respectively),whereas cyp2c19*17 mutant improved platelet reactivity (97.17 ± 45.38 vs. 169.08 ± 57.15,p = 0.003). however,there were no further cardiovascular deaths in endpoint patients. conclusion: in han chinese people of mainland china,clopidogrel‑related gene polymorphisms are related to variable platelet reactivity after clopidogrel maintenance dosing,which influences major adverse cardiovascular events,without an effect on cardiac death. © 2016 journal of research in medical sciences.