CYP2C19 gene-guided clopidogrel therapy improved total efficacy and significantly reduced adverse cardiovascular events compared to conventional treatment (P<0.05).
Does CYP2C19 gene detection-guided antiplatelet therapy improve clinical efficacy and reduce major adverse cardiac events in patients with coronary atherosclerotic heart disease compared to conventional clopidogrel treatment?
Genotype-guided antiplatelet therapy using CYP2C19 testing improves clinical outcomes and reduces cardiovascular events in patients with coronary heart disease compared to standard clopidogrel therapy.
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Abstract Background The main cause of coronary atherosclerotic heart disease (referred to as coronary heart disease for short) is insufficient blood supply to the coronary arteries, which leads to hypoxia and ischemia in the myocardial tissue and eventually results in chest pain and other consequences. For patients with acute coronary syndrome, antiplatelet therapy is an effective means to prevent thrombosis. In addition, clopidogrel is a second-generation antiplatelet aggregation drug. Conducting genetic testing on patients before use can better enhance the therapeutic effect of the drug. Current research mainly focuses on patients with coronary heart disease who undergo percutaneous coronary intervention (PCI), while there are not many studies on the treatment methods for patients with coronary heart disease who do not undergo PCI. In our work the individualized selection of second-generation antiplatelet aggregation drugs based on genotype testing results can significantly improve the prognosis of patients with coronary heart disease. Purpose This work aims to explore the application effect of CYP2C19 gene detection in clopidogrel treatment for patients with coronary heart disease, thereby improving the prognosis of patients with coronary atherosclerotic heart disease. Methods 50 patients with coronary atherosclerotic heart disease were divided into the observation group (n=25) and the control group (n=25). The control group was given conventional clopidogrel treatment. The observation group all conducted CYP2C19 gene polymorphism testing and appropriately adjusted the dosage of clopidogrel and replaced the antiplatelet drugs based on the differences in CYP2C19 genotypes. The clinical efficacy, incidence of major adverse cardiac events, and occurrence of bleeding adverse reactions of the two groups were observed. Results After 12 months of treatment, the total effective rate of the observation group was higher than that of the control group (P0.05), and the incidence of adverse cardiovascular endpoints in the observation group was significantly lower than that in the control group (P0.05). There was no significant difference in various bleeding adverse reactions between the two groups. Conclusion Based on the results of CYP2C19 gene polymorphism testing, adjusting the medication regimen of clopidogrel or replacing antiplatelet drugs can effectively improve the prognosis of patients with coronary atherosclerotic heart disease, reduce the occurrence of cardiovascular adverse events, and enable patients to obtain greater benefits.
Gong et al. (Thu,) reported a other. CYP2C19 gene-guided clopidogrel therapy improved total efficacy and significantly reduced adverse cardiovascular events compared to conventional treatment (P<0.05).