title: Relationship between clopidogrel-related polymorphisms and variable platelet reactivity at 1 year: A cohort study from Han Chinese.
abstract: BACKGROUND
  This study was designed to investigate the effect of clopidogrel-related gene polymorphisms on platelet reactivity and clinical outcome in Chinese Han patients.
  
  
  METHODS
  Three hundred and thirty-six percutaneous coronary intervention - treated patients were recruited and followed for 1 year. Blood samples were collected from all patients for DNA genotyping. The platelet reactivity unit was measured by the VerifyNow technique. The CYP2C19*2, CYP2C19*3, CYP2C19*17, ATP-binding cassette subfamily B member 1, ITGB3, CYP2C9*3, CYP2B6*9, and P2Y12 alleles were assessed.
  
  
  RESULTS
  The clinical endpoints were related to previous heart disease history (11.90% vs. 28.57%,P= 0.017), stroke (12.24% vs. 16.67%,P= 0.039), and diabetes (27.55% vs. 52.38%,P= 0.047). High on-treatment platelet reactivity (HTPR) was frequent in advanced age (P= 0.019), male gender (P= 0.016), hypertension (P= 0.033), and chronic renal failure (P= 0.040). There were more endpoints in the CYP2C19*2 and P2Y12 mutant carriers (76.19% vs. 43.20%,P< 0.001; 50.00% vs. 35.71%,P= 0.001, respectively), whereas fewer in the CYP2C19*17 mutant carriers (11.90% vs. 56.46%,P= 0.001). CYP2C19*2 and P2Y12 polymorphism manifested HTPR (194.25 ± 45.91 vs. 151.38 ± 58.14,P< 0.001; 180.33 ± 67.25 vs. 161.89 ± 56.49,P= 0.008, respectively), whereas CYP2C19*17 mutant improved platelet reactivity (97.17 ± 45.38 vs. 169.08 ± 57.15,P= 0.003). However, there were no further cardiovascular deaths in endpoint patients.
  
  
  CONCLUSIONS
  In Han Chinese people of mainland China, clopidogrel-related gene polymorphisms are related to variable platelet reactivity after clopidogrel maintenance dosing, which influences major adverse cardiovascular events, without an effect on cardiac death.
authors.affiliation: Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Lai
authors.affiliation: Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China.
authors.forename: Xumin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Cardiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.
authors.forename: Zi
authors.initials: Z
authors.lastname: Ye
authors.affiliation: Department of Cardiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.
authors.forename: Jiani
authors.initials: J
authors.lastname: Tang
authors.affiliation: Department of Cardiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.
authors.forename: Xuebo
authors.initials: X
authors.lastname: Liu
keywords: Clopidogrel; VerifyNow; polymorphism