Correlation between CYP2C19 gene polymorphism and clinical efficacy of clopidogrel in patients with coronary artery heart disease

Objective: To investigate the correlation between CYP2C19 genotype polymorphisms in the CYP450 enzyme and the clinical efficacy of clopidogrel in patients with coronary artery heart disease (CHD). Methods: A total of 300 patients with CHD admitted to our hospital were divided into the clopidogrel normal response group (NCLR) (n = 152) and the clopidogrel basal response group (CLR) (n = 148), according to adenosine diphosphate (ADP)and thromboelastography (TEG)-induced platelet inhibition ratio. The results of CYP2C19 genotype detection were classified into weak metabolism, middle and fast metabolism in order to find the relationship between poor clopidogrel to response with a CYP2C19 genotype. Results: There were significant differences in gender, smoking history, drinking history, aspartate aminotransferase (AST), platelet count (PLT), CYP2C19 genotype and triacylglycerol (TG) between the CLR group and NCLR group (P < 0.05). Little statistical significance was found with differences in hypertension, diabetes mellitus (DM), age, body mass index (BMI), low-density lipoprotein (LDL-C) and high density lipoprotein (HDL-C) between the two groups (P > 0.05); the same was true between middle and weak metabolism in the CYP2C19 genotype detection (P = 0.063). The 3 types of metabolism showed notably different clopidogrel responses (P < 0.05). Multivariate logistic regression analysis found a relationship between CYP2C19 gene polymorphism, AST and PLT indicators with clopidogrel response (P < 0.05). ROC curves revealed the important value of CYP2C19 genotype detection in predicting clopidogrel responces. Conclusion: A poor clopidogrel response in CHD patients was correlated with CYP2C19 genotype polymorphisms. Recommended dosage of antiplatelet drugs may be changed in the light of the detection for a CYP2C19 genotype when applied in clinical practice.