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Correlation between ABCB1 and CYP2C19 genotype and efficacy of clopidogrel in patients with atherosclerotic cerebral infarction
Received:March 29, 2019  Revised:October 08, 2019  Click here to download the full text
Citation of this paper:LI Xiao-xiao,Lü Jia-ning,WU Xu-qing,FAN Wei.Correlation between ABCB1 and CYP2C19 genotype and efficacy of clopidogrel in patients with atherosclerotic cerebral infarction[J].Chinese Journal of Clinical Medicine,2019,26(6):827-833
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Author NameAffiliationE-mail
LI Xiao-xiao Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai 200032, China  
Lü Jia-ning Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai 200032, China  
WU Xu-qing Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai 200032, China wu.xuqing@zs-hospital.sh.cn 
FAN Wei Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai 200032, China  
Abstract:Objective: To explore the relationship between ABCB1 and CYP2C19 genotype and efficacy of clopidogrel in patients with acute atherosclerotic cerebral infarction. Methods: Totally, 115 inpatients within 7 days after the onset of acute atherosclerotic cerebral infarction were assigned to three groups according to CYP2C19 genotype:extensive metabolizers,intermediate metabolizers, and poor metabolizers. Then, according to ABCB1 genotype, patients were divided into wild type and mutant type. Moreover, according to the number of gene mutations, patients were grouped into A (absence of variant CYP2C19 and ABCB1), B (either variant CYP2C19 or ABCB1), and C (both variant CYP2C19 and ABCB1). All the patients were treated with conventional treatments in the stroke unit, and thrombelastogram (TEG) was used to test platelet function and platelet inhibition ratio after patients taking clopidogrel for seven days. On admission and after taking clopidogrel for seven days, all the patients were evaluated by neurologic function scales including the National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Results: The patients of extensive metabolizers, intermediate metabolizers, and poor metabolizers were 46, 48 (40 *1/*2, 8 *1/*3), and 21 (18 *2/*2, 3 *2/*3), respectively. The patients of wild type and mutant type were 49 and 66. The number of patients of Group A, B, and C was 23, 50, and 42, respectively. Among different genotype of CYP2C19, ABCB1, and number of gene mutations, there were no significant differences in the platelet inhibition ratio, platelet function and neurologic function variety during the acute phase of stroke. Conclusions: In patients with acute atherosclerotic cerebral infarction in our study, the effect of the gene polymorphism of CYP2C19 and ABCB1 on clopidogrel has not been observed.
keywords:ABCB1 gene  CYP2C19 gene  clopidogrel resistance  acute  atherosclerotic cerebral infarction
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