Effect of the CYP2C19 *2,*3 non-functional allele on the curative effect of clopidogrel after PCI in Han and Uygur patients

Objective: To compare the effects of the CYP2C19 *2,*3 non-functional allele on the curative effect of clopidogrel after percutaneous coronary stent implantation(PCI) between Han and Uygur patients.Methods: Four hundred acute coronary syndrome patients treated with PCI were divided into the clopidogrel normal metabolish group(group A) and weak clopidogrel normal metabolish group(group B) according to the result of CYP2C19 genetic testing.The group A and group B were treated with 75 mg and 150 mg of clopidogrel,respectively.Two groups were followed up for (30±3)d.The recurrences of the acute myocardial infarction,angina,cardiac death,stent thrombosis,nonfatal stroke,fatal and life-threatening bleeding were the primary endpoint events,and the minor bleeding and slight bleeding were the secondary endpoint events.The incidence of the endpoint event between two groups were compared.Results: The differences of the recurrence rate of the acute myocardial infarction(2.34% and 1.47%),angina(6.25% and 5.88%),cardiac death(0.78% and 0.00%),stent thrombosis(1.56% and 0.00%),and bleeding(5.47% and 7.35%) between Han and Uygur patients in group A were not statistically significant(P>0.05).The differences of the recurrence rate of the acute myocardial infarction(1.87% and 0.00%),angina(5.61% and 4.76%) and bleeding(3.74% and 4.76%) between Han and Uygur patients in group B were not statistically significant(P>0.05),and the cardiac death,stent thrombosis,nonfatal stroke,fatal and life-threatening bleeding were not found in Han and Uygur patients of group B.The differences of the recurrence rate of the acute myocardial infarction,angina and bleeding in Uygur patients between group A and group B were not statistically significant(P>0.05),and the cardiac death,stent thrombosis,nonfatal stroke,fatal and life-threatening bleeding were not found in Uygur patients of group A and group B.Conclusions: Among Uighur patients with the CYP2C19*2,*3 non-functional allele,the treatment of 150mg of clopidogrel per day can weaken the clopidogrel resistance,effectively reduce the incidence of major cardiovascular events,and does not increase the risk of bleeding.