Secondary Prevention Effect Of Aspirin,Clopidogrel And Cilostazol Guided By Gene Polymorphism Testing In High-Risk Cerebral Infarction

Objective: To explore the significance of gene polymorphism detection in the selection of Aspirin,Clopidogrel and Cilotazol for the treatment of high-risk patients with cerebral infarction.Methods: This article collected 200 high-risk cerebral infarction patients hospitalized in Fuzhou Second Hospital(from October 2017 to October 2018),and randomly divided them into into an experimental group(100 cases)and a control group(100cases).We collected their general information,personal history,past history,laboratory test results,NIHSS scores and MRS scores at the time of admission.The experimental group detected 7 gene loci of patients: CYP2C19*2 rs4244285,CYP2C19*3 rs4986893,COX-1 rs1330344,COX-2 rs20417,GPIIb rs5911,P2Y12 rs3732759 and CYP3A5rs776746,and recommended drug therapy after passing the detection of gene polymorphism.The control group was treated with the antiplatelet aggregation drugs recommended in the current guidelines.Follow-up was performed at 3,6,and 12 months and the number of endpoint events and the specific time of occurrence were recorded.The allele frequency and genotype frequency of the gene loci involved in this study were tested for Hardy-Weinberg genetic balance.We used Chi-Square test to compare the incidence of endpoint events between the two groups,and to compare the incidence of endpoint events in the two groups within 3,6 and 12 months.We used Kaplan-Meier method(also known as product limit method)to analyze the survival of patients in the two groups,and the time difference of endpoint events within 12 months was compared between the two groups.The COX model was introduced for multivariate analysis,and the relationship between the 12 factors including "whether genetic polymorphism detection","sex","age",and "LDL value" and the incidence of endpoint events were examined.Results: The general clinical data of the two groups had no significant difference.Allele frequency and genotype frequency of the gene loci involved in this study were consistent with the Hardy-Weinberg genetic equilibrium law.After 12 months of follow-up,the incidence of endpoint events in the experimental group within 3 months,6 months,and 12 months was much lower than that of the control group(P <0.05).Within 12 months,the endpoint event of the patients in the experimental group occurred later than the control group."Whether to test for genetic polymorphisms" was significantly correlated with "the incidence of endpoint events".Conclusion:The detection of genetic polymorphism of the antiplatelet drugs Aspirin,Clopidogrel and Cilostazol can significantly reduce the risk of recurrence of cerebral infarction in patients with high-risk cerebral infarction within 12 months after antiplatelet therapy.