A randomized controlled trial of adjunctive Bunchang Naoxintong Capsule versus maintenance dose clopidogrel in patients with CYP2C19*2 polymorphism
A randomized controlled trial of adjunctive Bunchang Naoxintong Capsule versus maintenance dose clopidogrel in patients with CYP2C19*2 polymorphism
复制标题
CYP2C192基因多态性患者辅助用本昌脑心通胶囊与维持剂量氯吡格雷的随机对照研究
DOI：
10.1007/s11655-014-2023-z
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发表时间：
2014-12-01
影响因子：
2.9
通讯作者：
Wang Huan
中科院分区：
文献类型：
--
作者：
Chen Hui;Wu Xiao-ying;Wang Huan
为探讨步长脑心通胶囊对细胞色素P450 2C 19 *2（CYP 2C 19 *2）基因多态性患者行经皮冠状动脉介入治疗（PCI）后双重抗血小板治疗的影响，选择90例CYP 2C 19 *2基因多态性患者，采用聚合酶链反应（PCR）技术检测其基因型。使用计算机生成的随机序列和密封信封，将患者随机分配接受辅助NXT（三重组，45例）或双重抗血小板治疗（双重组，45例）。在基线和治疗后7天用常规聚集测定法评估血小板功能。在12个月的随访中记录了随后的主要不良心血管事件（MACE，包括心脏骤停和急性冠脉综合征），两组基线血小板功能测量结果相似。7天后，三联治疗组的最大血小板聚集抑制率和晚期血小板聚集抑制率显著高于双联治疗组（分别为42.3%+/- 16.0% vs. 20.8%+/-15.2%，P < 0.01和54.7%+/- 18.3% vs. 21.5%+/-29.2%，P < 0.01）。随访12个月，三联治疗组MACE发生率（6/45）明显低于双联治疗组（14/45; P <0. 05），NXT联合维持剂量氯吡格雷（75 g）可增强CYP 2C 19 *2多态性PCI患者的抗血小板作用，减少MACE发生。
To determine the impact of adjunctive Buchang Naoxintong Capsule (aeyene center dot e"a integral eEuroee integral a > S, NXT) on dual antiplatelet therapy in patients with cytochrome P450 2C19*2 (CYP2C19*2) polymorphism undergoing percutaneous coronary intervention (PCI).Ninety patients with CYP2C19*2 polymorphism were enrolled, and their genotypes were confirmed by polymerase chain reaction (PCR). The patients were randomly assigned to receive either adjunctive NXT (triple group, 45 cases) or dual antiplatelet therapy (dual group, 45 cases) using a computer-generated randomization sequence and sealed envelopes. Platelet function was assessed at baseline and 7 days after treatment with conventional aggregometry. Subsequent major adverse cardiovascular events (MACE, including sudden cardiac arrest and acute coronary syndrome) were recorded during a 12-month follow-up.Baseline platelet function measurements were similar in both groups. After 7 days, percent inhibitions of maximum platelet aggregation and late platelet aggregation were significantly greater in the triple versus dual group (42.3%+/- 16.0% vs. 20.8%+/- 15.2%, P < 0.01, and 54.7%+/- 18.3% vs. 21.5%+/- 29.2%, P < 0.01, respectively). During the 12-month follow-up, the rate of subsequent MACE (6/45) was significantly lower in the triple group compared with the dual group (14/45; P < 0.05).Adjunctive NXT to maintenance dose clopidogrel (75 g) could enhance the antiplatelet effect and decrease subsequent MACE in patients with the CYP2C19*2 polymorphism undergoing PCI.