Effect of platelet receptor gene polymorphisms on outcomes in ST-elevation myocardial infarction patients after percutaneous coronary intervention
Effect of platelet receptor gene polymorphisms on outcomes in ST-elevation myocardial infarction patients after percutaneous coronary intervention
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DOI：
10.3109/09537104.2015.1034096
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发表时间：
2016-01-02
期刊：
影响因子：
3.3
通讯作者：
Yuan, Jin-Qing
中科院分区：
文献类型：
--
作者：
Zhang, Jia-Hui;Wang, Jing;Yuan, Jin-Qing
血小板受体基因的多态性可能影响血小板功能。本研究旨在评估血小板受体编码基因的五种多态性对经皮冠状动脉介入治疗（PCI）后ST段抬高型心肌梗死（STEMI）患者缺血和出血事件风险的影响。 503 名连续发生 STEMI 的中国患者在顺利接受 PCI 后接受了 12 个月的标准双联抗血小板治疗。血小板受体、GPIa（ITGA2、807C>T、rs1126643）、GPVI（GP6、13254T>C、rs1613662）、PAR-1（F2R、IVS-14A>T、rs168753）和 P2Y12（P2RY12、34C>T）的多态性，通过连接酶检测反应检测到rs6785930和H1/H2单倍型，52G>T，rs6809699)。随访期为12个月。总体而言，发生了 34 起（6.8%）缺血事件和 46 起（9.1%）大出血。多变量 Cox 回归分析显示，在调整既定风险因素后，F2R rs168753 小等位基因的携带是复合缺血事件的独立预测因子（HR 0.387，95% CI 0.193-0.778，p=0.008）。多变量逻辑回归模型发现，携带 P2RY12 rs6809699 小等位基因（OR 2.71，95% CI 1.298-5.659，p=0.008）是大出血的独立预测因子。然后，这些关联在第二组 483 名 STEMI 患者中得到验证。在 PCI 术后的 STEMI 患者中，F2R rs168753 小等位基因可能显着增加缺血事件的风险，而 P2RY12 rs6809699 小等位基因可以预测出血。血小板受体的基因检测对于预测 STEMI 患者 PCI 后的不良事件很有价值。
Polymorphisms in platelet receptor genes may influence platelet function. This study aimed to assess the impact of five polymorphisms of genes encoding platelet receptors on the risk of ischemic and bleeding events in ST-elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI). 503 consecutive Chinese patients with STEMI after an uneventful PCI and exposed to standard dual antiplatelet therapy for 12 months were enrolled. Polymorphisms of platelet receptors, GPIa (ITGA2, 807C>T, rs1126643), GPVI (GP6, 13254T>C, rs1613662), PAR-1 (F2R, IVS-14A>T, rs168753) and P2Y12 (P2RY12, 34C>T, rs6785930 and H1/H2 haplotype, 52G>T, rs6809699) were detected by the ligase detection reaction. The follow-up period was 12 months. Overall, 34 (6.8%) ischemic events occurred and 46 (9.1%) major bleedings occurred. Multivariate Cox regression analysis showed the carriage of F2R rs168753 minor allele was an independent predictor of the composite ischemic events (HR 0.387, 95% CI 0.193-0.778, p=0.008) after adjusted for established risk factors. Multivariate logistic regression model identified that carriage of P2RY12 rs6809699 minor allele (OR 2.71, 95% CI 1.298-5.659, p=0.008) was an independent predictor of major bleedings. The associations were then validated in a second cohort of 483 STEMI patients. In STEMI patients after PCI, F2R rs168753 minor allele could significantly contribute to the risk of ischemic events, and P2RY12 rs6809699 minor allele could predict bleedings. The genetic testing of platelet receptors can be valuable in predicting adverse events in STEMI patients after PCI.