在中国人群中,Clopidogrel治疗期间,CYP2C19功能丧失变体与长期缺血性中风事件相关
Peng Wu1, Ziqing Liu2, Zijian Tian3
1Guangzhou Laboratory, Guangzhou International Bio Island, Guangzhou, China.
Clinical pharmacology and therapeutics
|August 22, 2023
概括
患有CYP2C19功能丧失变体的克洛皮多格雷尔患者患缺血性中风的风险更高. 基因型导向疗法是必要的个性化抗血小板治疗在初级保健.
科学领域:
- 药物遗传学 药物遗传学
- 心血管医学 心血管医学
- 基因组学就是基因组学.
背景情况:
- 克洛皮多格雷尔是一种广泛使用的抗血小板药物.
- CYP2C19遗传变异可能会影响克洛皮多格雷尔的疗效.
- 在CYP2C19中功能丧失 (LoF) 变体可能会降低克洛皮多格雷尔的抗血小板作用,可能会增加血栓形成风险.
研究的目的:
- 调查CYP2C19功能丧失 (LoF) 变体与长期缺血性中风风险之间的关联.
- 评估接受克洛皮多格雷尔治疗的中国初级保健患者中CYP2C19基因型的临床意义.
主要方法:
- 使用电子病历和中国初级保健患者 (n=1,141) 的生物银行数据进行了回顾性队列研究,这些患者接受了皮多格雷尔治疗.
- 针对两个主要的CYP2C19LoF变体 (*2和*3) 的基因定型.
- 考克斯回归分析以评估缺血性中风风险,调整临床共变量.
主要成果:
- 61.9%的患者携带至少一种CYP2C19LoF变异.
- 在平均12个月的随访期间,9.0%的患者患上了缺血性中风.
- 经调整后,携带CYP2C19LoF变异的携带者显示出缺血性中风的风险显著增加 (HR: 1.64,95%CI: 1.06-2.53,P=0.025).
结论:
- CYP2C19 LoF变体与中国患者治疗克洛皮多格雷尔的缺血性中风的长期风险增加有关.
- 这些发现强调了在初级保健机构中需要基于CYP2C19基因型的个性化抗血小板治疗.
- 药物遗传测试可以告知个性化皮多格雷尔的处方,以优化中风预防.
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