The Distribution Characteristics Of CYP2C19 Gene Polymorphism In Suzhou Area And Its Effect On Clinical Outcomes In Patients With Acute Cerebral Infarction

Objective: The first part is to study the distribution characteristics of CYP2C19 gene polymorphism in 692 cases of Han nationality in Suzhou area,and to compare the polymorphisms of CYP2C19 gene in regions countries and races.The second part explores the effect of CYP2C19*2 and CYP2C19*3 loss-of-function alleles on recurrent clinical ischemic events in patients with acute cerebral infarction.Methods: A total of 692 patients who were admitted to the First Affiliated Hospital of Soochow University from February 2016 to February 2017 were collected.All of them were Han population in Suzhou Jiangsu Province.Pyrosequencing was used to detect CYP2C19 gene in 692 patients.The main detection contents were CYP2C19*2(681 G/A,rs4244285)and CYP2C19*3(636 G/A,rs4986893)gene sequences.The CYP2C19 gene polymorphisms in different regions countries and ethnicities were searched by using the keywords “CYP2C19” and “gene polymorphisms” to compare the ethnic differences of CYP2C19 gene polymorphisms.Enrolled in 212 patients with acute non-cardiac cerebral infarction who were hospitalized in neurology department from 692 cases.Their basic information and clinical data were collected and for one-year-old follow-up.To discusses the association among CYP2C19 * 2/*3 loss of function alleles with clinical outcomes of cerebral infarction.SPSS 17.0 statistical software for data processing.Results: 1.The distribution of CYP2C19 polymorphisms in 692 suzhou han populations This 692 patients CYP2C19*1/*2 and *3 frequency was 61.99%,33.45% and 61.99% respectively.Wild homozygous(CYP2C19*1/*1)was 38.58%,the mutant CYP2C19*1/*2,CYP2C19*1/*3,CYP2C19*2/*2,CYP2C19*2/*3,CYP2C19*3/*3 frequency was 41.04%,5.78%,11.56%,2.75%,0.29% respectively.Extensive metabolism,intermediary metabolism and poor metabolism was 38.58%,46.82% and 38.58% respectively.2.The CYP2C19 polymorphisms of the regional national and racial diversity Suzhou Han population's CYP2C19*2 loss function alleles frequency was significantly higher than Mongolian and Uygur(P<0.05).CYP2C19*2 loss of function alleles frequency was significantly higher than Uygur and significantly lower than Hui and Han populations(P<0.05).Suzhou Han population's intermediary metabolism frequency was significantly higher than Hui populations Uygur and Caucasian(P<0.05).Poor metabolism frequency was significantly higher than Mongolian Uygur and Caucasian(P<0.05).3.The CYP2C19*2 and *3 LOF carriers and noncarriers general data comparison General data such as,age,gender,medical history,antiplatelet therapy,NIHSS score,TOAST classification,Stenosis of grading,associated with drugs,hypertension,2 type diabetes,smoking,laboratory indicators are no significant difference between with carriers and noncarriers(P>0.05).4.Statistical analysis of the end point events Primary end point events in 198 patients with 40(20.2%)cases and with 2(1.0%)cases secondary end point events.CYP2C19*2 and *3 LOF carriers' primary end point events is significantly higher than noncarriers(32 25.4% vs 8 11.1%,P =0.016)and recurrent cerebral infarction is also significantly higher(25 19.8% : 5 6.9%,P =0.015).5.The influence factors of the primary end point events analysis CYP2C19*2 and *3 LOF carriers,oral clopidogrel 50mg/d to antiplatelet therapy and hypertension is major influence factors of the primary end point events P< 0.05.And logistic regression analysis found that CYP2C19*2 and *3 LOF carriers(OR=2.50 95%CI:1.07~5.86 P=0.035)and hypertension(OR=2.39 95%CI:1.05~5.43 P=0.038)is independent risk factors for the primary end point events.Conclusions: 1.The frequency of CYP2C19*2 and CYP2C19*3 loss of function alleles in the 692 Han population in Suzhou area was relatively high,accounting for 38.01%.2.The distribution of CYP2C19 gene polymorphisms has regional and ethnic differences.3.The incidence of adverse clinical ischemic events was significantly higher in carriers with CYP2C19*2 and *3 allergic alleles than non-carriers.4.The carriers of CYP2C19*2 and *3 loss of function alleles and hypertension are all risk factors for adverse clinical ischemic events.