Association Of P2Y12 Gene Polymorphisms (C34T And G52T) With Clopidogrel Resistance And Clinical Outcome After Percutaneous Coronary Intervention In Patients With Acute Coronary Syndrome

Objective: To investigate the platelet ADP receptor P2Y12 gene C34 T and G52 T loci mutation in patients with coronary heart disease according to law after clopidogrel whether clopidogrel resistance(CR)and the correlation between the assessment for CR;percutaneous coronary artery stent implantation(PCI)of the patients with coronary heart disease prognosis impact.Methods: from January 2015 to December 2015 the formal dual antiplatelet Department of Cardiology in our hospital treatment of 249 patients with coronary heart disease concurrent PCI surgery patients,using gene chip technology to detect platelet ADP receptor P2Y12 gene C34 T and G52 T two loci mutation,and according to whether the mutations were divided,according to the results divided into C34 T mutation group(CT+TT type)/ non mutation group(CC),G52 T mutation group(GT+TT type)/ non mutation group(type GG).Then every bit of patients taking clopidogrel and regular use of a week after the rate of platelet aggregation,if clopidogrel in patients before and after the platelet aggregation rate difference is less than 10%,which will be set for clopidogrel resistance.At the same time,according to the results of coronary angiography,the number of coronary artery lesions and the Gensini score were calculated.At last,the patients were followed up in the hospital,and the patients were followed up by telephone or clinic for at least 3 months after discharge.Results: of the 249 patients,there were male and female,with a mean age of(64.8 +11.1)years,with a mean age of 94 years(range,155 +).In the C34 T site: 162 cases of type CC(65.1%),87 cases of type CT+TT(34.9%),the frequency of allele C: 73.9%,T allele frequency of G52 T locus in 26.1%,GG in 198 cases(79.5%),51 cases of type GT+TT(20.5%),G allele frequency: 85.5%.T allele frequency: 14.5%.Comparison of baseline data: G52 T loci in GT+TT group were age and proportion of males is higher than that of GG group,there was significant difference(P<0.05);therewere no significant differences between the two groups of patients with hypertension,smoking,diabetes,biochemical index(P>0.05).However,there was no significant difference in the age,sex and other baseline data of C34 T gene(P value was >0.05).Multivariate Logistic regression analysis showed that C34 T locus CT+TT CR incidence rate was higher than that in CC group,is an independent predictor of CR(OR:2.588,95%CI:1.4022-4.777,P<0.01);the two groups were followed up for 3months to 12 months,the incidence of cardiovascular events increased significantly compared with GG group,PCI G52 T of locus GT+TT after the group(P<0.05);Gensini group number and coronary lesion score showed no significant difference.Conclusion: P2Y12 gene polymorphism(C34T and G52T)is closely associated with clopidogrel resistance in patients with acute coronary syndrome(ACS)and clinical outcome after percutaneous coronary intervention(PCI).The mutation of G52 T gene locus may have adverse effects on the prognosis of patients with coronary heart disease(CHD)undergoing PCI surgery,and the incidence of cardiovascular events was significantly increased,while the C34 T mutation had no direct effect on the prognosis of patients with coronary heart disease(CHD).P2Y12 gene C34 T mutation is an independent factor of CR,indicating that the C34 T mutation gene has a negative impact on the anti platelet aggregation effect of clopidogrel.