Impact of Total Protein Level and Dysglycaemia on the Efficacy of Clopidogrel in Patients Underwent Carotid Artery Stenosis with CYP2C19 Genetic Variants

BACKGROUND: CYP2C19 polymorphisms are associated with the increased risk of major adverse cardiovascular/cerebrovascular events (MACCEs) in cerebral intervention. In this study, we wanted to investigate whether the CYP2C19 polymorphism and other nongenetic factors can influence the incidence of MACCEs in cerebral artery stenosis disease patients. METHODS: A total of 164 patients underwent cerebral artery stenting and 138 patients underwent conservative treatment among 1406 who patients underwent CYP2C19 gene screening and were enrolled in this study. A Cox proportional hazards model and Kaplan–Meier analyses were used to assess the predictive value of CYP2C19 loss-of-function (LOF) allele (*2, *3) carrier status and other risk factors. RESULTS: The CYP2C19 *1/*1 genotype was observed to be the most predominant among the patients (41.96%). The patients who underwent conservative treatment and had glucose levels> 6.5 mmol/L were more likely to experience MACCEs (p = 0.022). CYP2C19 LOF allele variants (p = 0.032), total protein < 65 g/L (p = 0.017) and glucose > 6.5 mmol/L (p = 0.028) were associated with an increased risk of MACCEs in patients who underwent cerebral artery stents in the multivariable Cox analysis. CONCLUSION: CYP2C19 polymorphisms, total protein levels and glucose can impact the risk of MACCEs in patients who undergo cerebral artery stents.