Relationship Between The Polymorphism Of Cytochrome 3A4+894C>T P450 Gene And Prognosis After Coronary Intervention In Patients With Acute Coronary Syndrome

Objective: Study of the relationship between acute coronary syndrome(ACS)plasma cytochrome P450 3A4(CYP3A4)894C>T gene polymorphism and Risk of recurrence of adverse cardiac events after percutaneous coronary intervention(PCI)treatment.In order to clarify whether the polymorphism of CYP3A4 894C>T gene has a guiding significance for the treatment of patients with PCI after surgery.Methods: Selected 275 cases in our hospital department of Cardiology Anhui Han ACS patients,After admission,each patient was treated with aspirin,clopidogrel and PCI.The venous blood was collected from each patient before and after taking 7d,and the platelet aggregation rate(PAR)was detected by two adenosine monophosphate(ADP),twice difference is less than or equal to 10% defined as clopidogrel resistance(CR),Patients were divided into clopidogrel resistance group(group CR)and non clopidogrel resistance group(group NCR);Gene type and allele distribution of single nucleotide polymorphism of CYP3A4 894C>T gene in each group were detected by fluorescence quantitative polymerase chain reaction(Polymerase Chain Reaction PCR)technique.PCI was used to determine the number,location and extent of coronary lesions in each patient,and the Gensini score was calculated.The patients were followed up by telephone or clinic for 12 months.Results: Of the 275 patients enrolled in this study,There are 275 males and 107 females,with an average age of(62.9 + 10.9)years old.A total of 108 patients(39.3%)were defined as CR,CR group of 108 cases,NCR group of 167 cases.CYP3A4 gene894C>T site is divided for CC,CT and TT genotypes,and in CR and NCR groups,each genotype number and frequency were 88(81.48%),19(17.59%),1(0.93%)and 128(76.65%),38(22.75%),1(0.60%),there was no statistically significant difference(P > 0.05).There was no significant difference in CYP3A4 gene polymorphism between CR group and NCR group(P>0.05).Multivariate Logistic regression analysis showed that there was no significant difference in the correlation between CYP3A4 gene 894C>T and CR in the T gene ACS locus(OR 1.359,P>0.05).Through the follow-up of 12 months,the incidence of cardiovascular events in CR group than in NCR group were higher(including recurrent angina pectoris,acute coronary syndrome,acute myocardial infarction,stent restenosis and cardiac sudden death)(P<0.05),However,it is not related to the polymorphism of CYP3A4 gene894C>T locus.Conclusions: The polymorphism of the CYP3A4 gene 894C>T site has no clear guiding significance for the anti-platelet effect and cardiovascular risk in patients with PCI after ACS.