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Abstract：
We investigated the effect of CYP2C19 polymorphisms on the clinical outcomes of clopidogrel therapy in patients after stenting procedure for cerebral artery stenosis in northeast China. 568 patients performed CYP2C19 genotype screening in the neurosurgery department of our hospital; 154 patients were finally recruited according to the inclusion and exclusion criteria, and followed-up for 6 months. Ischemic events including (1) transient ischemic attack (TIA); (2) stent thrombosis; (3) ischemic stroke; and (4) death were defined as primary clinical endpoints. The frequencies of CYP2C19*1, *2 and *3 alleles in 568 patients were 63.1%, 31.1% and 5.8%, respectively. 154 patients were classified into extensive (65 patients; 42.2%), intermediate (66 patients; 42.9%), and poor (23 patients; 14.9%) metabolizer groups. A χ2 test showed a significant difference in primary clinical endpoints at 6 months (P = 0.04), and a multivariate Cox regression analysis indicated that the CYP2C19 loss-of-function (LOF) alleles associated with post-procedure prognosis. The Kaplan-Meier curve revealed that there was no significant difference in ischemic events between *2 and *3 alleles carriers. Our study verifies that CYP2C19 *2 and *3 have significant impact on the clinical outcomes of clopidogrel therapy in patients with stenting procedure for cerebral artery stenosis in China.
摘要：
我们研究了CYP2C19多态性对中国东北地区脑动脉狭窄支架置入术后氯吡格雷治疗临床结局的影响。568例患者在我院神经外科进行CYP2C19基因型筛查;最终纳入154例患者,并随访6个月。缺血性事件包括(1)短暂性脑缺血发作(TIA);(2)支架内血栓形成;(3)缺血性卒中;和(4)死亡被定义为主要临床终点。568例患者中CYP2C19*1、*2和*3等位基因频率为63.1%,31.1%和5.8%，分别。154例患者分为广泛型（65例；42.2%），中级（66例；42.9%），和不良（23例；14.9％）代谢组。χ2检验显示6个月时主要临床终点有显著差异(P=0.04),多因素Cox回归分析显示CYP2C19功能缺失(LOF)等位基因与术后预后相关。Kaplan-Meier曲线显示，*2和*3等位基因携带者之间的缺血事件没有显着差异。我们的研究证实，CYP2C19*2和*3对中国脑动脉狭窄支架置入术患者氯吡格雷治疗的临床结局有显著影响。
