Efficacy and safety of CYP2C19 genotype-guided antiplatelet therapy in patients with coronary artery disease after percutaneous coronary intervention
WU Lang1,2, YANG Shengli1,2, ZHANG Lu2, LIU Ying2, YANG Yong2, and HUANG Jie2
1.Clinical College of General Hospital of Chinese People’s Armed Police Force, Anhui Medical University, Beijing 100039, China; 2. Department of Cardiology, General Hospital of Chinese People’s Armed Police Force,Beijing 100039, China
Abstract：Objective To evaluate the efficacy and safety of CYP2C19 genotype-guided antiplatelet therapy in patients with coronary artery disease(CAD) after percutaneous coronary intervention(PCI). Methods From April 2013 to February 2015, a total of 718 patients with CAD were admitted and received PCI in the Department of Cardiology, General Hospital of Chinese People’s Armed Police Forces. They were sequentially randomized into study group (n=359) and control group (n=359). In the study group, the CYP2C19 genotypes were detected. The extensive metabolizer (EM) group received clopidogrel 75 mg, qd, the intermediate metabolizer (IM) and poor metabolizer (PM) were randomly assigned to receive either high dose clopidogrel 150 mg, qd or ticagrelor 90mg, bid. The control group routinely received clopidogrel 75 mg, qd. At 6 months, the incidence of major adverse cardiac events (MACE) and bleeding events were observed in the clinical follow up. Results At 6 months follow up, the incidence of MACE in the study group was lower than in the control group (4.7% vs 8.9%,P=0.026). There were no significant difference in the incidence of bleeding events between the two groups(8.1% vs 6.7%,P=0.475). Conclusions In patients with CAD after PCI, CYP2C19 genotype-guided antiplatelet therapy can reduce the incidence of MACE,and does not increase the risk of bleeding event.
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2016, Vol. 27 
