Research On The Relationship Between CYP2C19Gene Polymorphisms And The Prognosis Of Patients With Coronary Heart Disease Taking Clopidogrel, ALDH2Gene Polymorphism And Myocardial Infarction

Objective:To investigate the impact of CYP2C19gene polymorphism on clinical outcome in patients with coronary heart disease taking clopidogrel after PCI and to explore the correlation of ALDH2gene polymorphism and myocardial infarction. Thus, to provide a theoretical basis for clinical treatment.Methods:1.722patients were selected from June2012to November2013. Logistic regression analysis was employed to evaluate the associated risk factors that affect coronary artery disease, particularly myocardial infarction.2.112coronary heart disease patients taking clopidogrel undergoing PCI and90patients without coronary heart disease were detected CYP2C19gene polymorphism. Follow-up112coronary heart disease patients taking clopidogrel after PCI for12months. Cox regression analysis evaluate the impact CYP2C19gene polymorphism on clinical outcomes in patients with coronary heart disease taking clopidogrel after PCI.3.111coronary heart disease patients and46patients without coronary heart disease were detected ALDH2gene polymorphism to evaluate the correlation of ALDH2gene polymorphism and MI.Results:1. Coronary heart disease is related to age, smoking, diabetes, hypertension, family history, LDL-C levels and HDL-C levels (P<0.05). Myocardial infarction is related to smoking, diabetes hypertension and HDL-C levels (P<0.05).2. There was no significant difference of CYP2C19gene mutation rate between coronary heart disease patients and patients without coronary heart disease (P>0.05). CYP2C19gene mutational coronary heart disease patients taking clopidogrel after PCI have a higher risk of the composite endpoint during12months than the CYP2C19gene wild type group.(HR=3.539,95%CI:1.344～9.320, P<0.05). The elder coronary heart disease patients have a higher risk of the composite endpoint during12months than the younger group.(HR=1.034,95%CI:1.001～1.068, P<0.05).3. The level of HDL-C in ALDH2gene mutational coronary heart disease patients is lower than ALDH2gene wild coronary heart disease patients (P<0.05). The patients with myocardial infarction have a significantly higher ALDH2gene mutation rate than the control group (P<0.05).Conclusion:1. The risk factors of coronary heart disease are age, smoking, diabetes, hypertension, family history and LDL-C levels. HDL-C level is a protective factor for coronary heart disease. The risk factors of myocardial infarction are smoking, diabetes and hypertension. HDL-C level is a protective factor for myocardial infarction.2. CYP2C19gene polymorphism and age are risk factors affecting the occurrence of MACE in patients taking clopidogrel with CHD after PCI. CYP2C19gene mutational coronary heart disease patients taking clopidogrel after PCI have a higher risk of the composite endpoint during12months than the CYP2C19gene wild type group.3. ALDH2gene mutation may reduce the level of HDL-C in patients with coronary heart disease. The ALDH2gene mutation may increase the risk of suffering from MI.