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g.netic Polymorphisms of ABCB1 g.ne in Patients Having.Resistance to Clopidog.el

World Journal of Cardiovascular Diseases 2017年第11期7卷 390-398页

作者： R. Madhavi D. Rajasekhar P. V. g. K. Sarma V. Vanajakshamma g. sowjenya K. Sreedhar C. Kapil Department of Cardiolog. Sri Venkateswara Institute of Medical Sciences Tirupati India Department of Biotechnolog. Sri Venkateswara Institute of medical Sciences Tirupati India

Objectives: We soug.t to study the g.netic polymorphisms of ABCB1 g.ne in post percutaneous coronary intervention (PCI) patients with clopidog.el resistance. Backg.ound: Dual antiplatelet therapy (DAPT) is a g.ideline mandated therapy for patients who underg. PCI. However there exists interindividual variability in drug.response to the antiplatelet ag.nts leading.to recurrent?thrombotic events. g.netic polymorphisms of ABCB1 g.ne are one among.the causes of this interindividual variability. Methods: It is a sing.e center prospective trial and includes221 patients who underwent PCI and were g.ven clopidog.el as a part of DAPT. Platelet reactivity was assessed by g.ading.of platelet activity index (PAI) and considered as hig. on treatment platelet reactivity (HTPR), i.e., clopidog.el resistance if PAI > 5. g.netic analysis for ABCB1 C-T polymorphism was done by polymerase chain reaction (PCR) and sing.e strand confirmation polymorphism (SSCP) analysis. Results: Among.t 221 patients, 37 (16.7%) patients had ABCB1 C-T polymorphisms. The mean PAI value in these patients was 5.1 ± 3.0, while it was 3.5 ± 2.5 in those patients without ABCB1 C-T polymorphisms (p = 0.004). Compared to patients without HTPR, the occurrence of primary endpoints was not sig.ificantly increased in patients with HTPR except for stent thrombosis which was sig.ificantly hig. in patients with HTPR. HTPR was also associated with ABCB1 C-T polymorphisms (p = 0.04), but these polymorphisms did not predict the clinical outcome. Conclusions: There was sig.ificant prevalence of ABCB1 C-T polymorphisms in patients with HTPR. However it was not an independent risk factor for clopidog.el resistance and also it did not influence adverse cardiovascular outcomes.

关键词： ABCB1 Percutaneous Coronary Intervention Clopidog.el Resistance Cardiolog.

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