Effects of Dual-Dose Clopidogrel, Clopidogrel Combined with Tongxinluo Capsule, and Ticagrelor on Patients with Coronary Heart Disease and CYP2C19*2 Gene Mutation After Percutaneous Coronary Interventions (PCI).
Effects of Dual-Dose Clopidogrel, Clopidogrel Combined with Tongxinluo Capsule, and Ticagrelor on Patients with Coronary Heart Disease and CYP2C19*2 Gene Mutation After Percutaneous Coronary Interventions (PCI).
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DOI：
10.12659/msm.903054
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发表时间：
2017-08-07
期刊：
影响因子：
--
通讯作者：
Qi P
中科院分区：
文献类型：
--
作者：
Chen S;Zhang Y;Wang L;Geng Y;Gu J;Hao Q;Wang H;Qi P
近年来，遗传因素作为心血管易感性的重要易感因素引起了人们的研究兴趣。本研究旨在探讨双剂量氯吡格雷、氯吡格雷联合通心络、替卡格雷对CYP2C19*2基因功能缺陷、氯吡格雷反应不良患者经皮冠状动脉介入治疗(PCI)后血小板活性及MACE事件的影响。选择458例冠心病患者行经皮冠状动脉介入治疗，采用TaqMan实时荧光定量聚合酶链式反应检测CYP2C19*2等位基因。最终纳入212例患者，分为4组：标准抗血小板组46例，氯吡格雷双倍剂量组50例，氯吡格雷联合通心络组59例，替卡格雷组57例。TEG法检测血小板抑制率。我们分析和比较了这4组患者在不同随访时间的血小板活性和MACE事件发生率的差异。结果表明，氯吡格雷双剂量组、氯吡格雷联合通心络组、替卡格雷组抑制血小板聚集作用优于常规剂量组，其中以替卡格雷效果最好。氯吡格雷双剂量组、氯吡格雷联合通心络组和替卡格雷组的MACE总发生率较低，而替卡格雷组出血发生率较高。调整剂量或与其他药物联合应用可提高抗血小板治疗的疗效，降低介入治疗后缺血事件的发生率。
In recent years, genetic factors have attracted research interest as important predisposing factors for cardiovascular susceptibility. This study aimed to investigate the influences of dual-dose clopidogrel, clopidogrel combined with tongxinluo, and ticagrelor on the platelet activity and MACE events of patients with CYP2C19*2 gene function deficiency and poor clopidogrel response after PCI. We selected 458 patients with coronary heart disease undergoing PCI, and the genotype of CYP2C19*2 was detected by TaqMan real-time PCR. We finally enrolled 212 patients and divided them into 4 groups: a standard anti-platelet group of 46 patients, a clopidogrel double-dose group of 50 cases, a clopidogrel combined with tongxinluo group of 59 cases, and a ticagrelor group of 57. The platelet inhibition rate was detected by TEG. We analyzed and compared differences in platelet activity and the occurrence of MACE events in these 4 groups at different follow-up times. The results showed that inhibition of platelet aggregation was better in the double-dose clopidogrel group, the clopidogrel combined with tongxinluo group, and the ticagrelor group than in the regular-dose clopidogrel group, and ticagrelor was the best. We also found that the total incidence of MACE was much lower in the double-dose clopidogrel group, the clopidogrel combined with tongxinluo group, and the ticagrelor group, while the incidence of hemorrhage in the ticagrelor group was higher. Adjusting the dose or combining with other drugs improves the efficacy of anti-platelet therapy and reduces the incidence of ischemic events after PCI.
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影响因子：
2.5
作者：
Ogawa, Hisao;Isshiki, Takaaki;Saito, Shigeru
通讯作者：
Saito, Shigeru
影响因子：
168.9
作者：
Collet, Jean-Philippe;Hulot, Jean-Sebastien;Montalescot, Gilles
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影响因子：
20.3
作者：
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DOI：
10.1161/circoutcomes.113.000321
发表时间：
2013-11-01
影响因子：
6.9
作者：
Desai, Nihar R.;Canestaro, William J.;Choudhry, Niteesh K.
通讯作者：
Choudhry, Niteesh K.
影响因子：
3
作者：
Wang, Xiaomei;Mu, Changzheng;Zhang, Zhimian
通讯作者：
Zhang, Zhimian