Comparison of loading with maintenance dose of clopidogrel on platelet reactivity in Chinese with different CYP2C19 genotypes prior to percutaneous coronary intervention
Comparison of loading with maintenance dose of clopidogrel on platelet reactivity in Chinese with different CYP2C19 genotypes prior to percutaneous coronary intervention
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DOI：
10.3760/cma.j.issn.0366-6999.20140069
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发表时间：
2014-07-20
影响因子：
6.1
通讯作者：
Li Yishi
中科院分区：
文献类型：
--
作者：
Zhang Xiaoxing;Yan Lirong;Li Yishi
背景在选择性经皮冠状动脉介入治疗(PCI)前，氯吡格雷的两种预处理策略：氯吡格雷初治患者的负荷剂量(LD)300 mg和接受慢性氯吡格雷治疗的患者每日一次的维持剂量(MD)是否在不同CYP2C19基因型的中国人的血小板抑制中起到相同的作用尚不清楚。方法将840例接受经皮冠状动脉介入治疗的患者按不同的氯吡格雷预处理策略(LD组470例，MD组370例)和CYP2C19基因携带者(其中494例为任何一种功能缺失等位基因携带者，346例为非携带者)分为2×2组。结果LD组血小板聚集率(59.22+/-11.67)%显著高于MD组(52.83+/-12.17)%，P
Background Whether two clopidogrel pretreatment strategies prior to elective percutaneous coronary intervention (PCI): a 300 mg loading dose (LD) in clopidogrel naive patients and a 75 mg maintenance dose (MD) once daily in patients on chronic clopidogrel therapy play the same role in the platelet inhibition in Chinese with different CYP2C19 genotypes remains unknown. We aim to evaluate the impact on platelet inhibition by clopidogrel pretreatment strategy and its interaction effect with CYP2C19 genotype.Methods Chinese patients undergoing PCI (n=840) were assigned to 2x2 groups in the trial according to different clopidogrel pretreatment strategies (470 patients in LD, 370 patients in MD) and CYP2C19 genotypes (494 carriers of any CYP2C19 *2 or *3 loss-of-function allele, 346 non-carriers). The primary outcome was platelet aggregation (PA) as measured by the 10 mu mol/L adenosine diphosphate induced light transmission aggregation.Results Compared with MD group, LD strategy showed a significantly higher PA-((59.22 +/- 11.67)% vs. (52.83 +/- 12.17)%, P