ĐẶC ĐIỂM VÀ MỐI LIÊN QUAN CỦA ĐA HÌNH GEN CYP2C19 VỚI ĐỀ KHÁNG CLOPIDOGREL Ở BỆNH NHÂN ĐẶT STENT ĐỘNG MẠCH VÀNH

Abstract

Objects: Investigating the characteristics and relationship between CYP2C19 gene polymorphism and clopidogrel resistance in patients following coronary artery stenting intervention. Subjects and methods: Cross-sectional descriptive study with 171 patients over 18 years old who were successfully intervented coronary artery stenting and treated with clopidogrel at 175 Military Hospital and 103 Military Hospital from 09/2021 to 12/2022. Results: The average age was 61.99±11.26. Male accounted for the majority (74.85%), common cardiovascular risk factors were: hypertension (78.36%), dyslipidemia (74.85%), overweight-obesity (49, 71%). The G and A allele frequencies of single nucleotide polymorphism (SNP) CYP2C19 G681A were 73.98% and 26.02%, respectively. The G and A allele frequencies of SNP CYP2C19 G636A were 92.98% and 7.02%, respectively. Intermediate metabolizer (IM) phenotype accounts for 40.35% and poor metabolizer (PM) phenotype accounts for 12.28%. The rate of clopidogrel resistance was higher in patients carrying the A allele of SNP CYP2C19 G681A when considered in co-dominant, dominant or recessive models with p<0.05. For SNP CYP2C19 G636A, patients carrying the A allele had a higher rate of clopidogrel resistance when examined in a co-dominant model or a dominant model with p<0.05. The patients with intermediate and poor metabolizer phenotypes had a higher rate of clopidgrel resistance than the group with metabolic phenotypes. normalized (32.75% vs. 19.88%) with p<0.05. Conclusion: SNP CYP2C19 G681A had 73.98% G and 26.02% A allele frequencies. SNP CYP2C19 G636A has 92.98% G and 7.02% A allele frequencies. The A allele of SNP CYP2C19 G681A and CYP2C19 G636A were associated with increasing clopidogrel resistance rate with p<0.05. The group of patients with IM+PM phenotypes had a higher clopidogrel resistance rate than the normal metabolic phenotype group with p<0.05