Bo Zhou, Chuanshen Shi, Qike Xu, Yujia Wei, ShuFang Zhang, Xia Wang, Xiangyang An
{"title":"ABCB1基因多态性与PCI术后氯吡格雷治疗患者高血糖和MACE的关系","authors":"Bo Zhou, Chuanshen Shi, Qike Xu, Yujia Wei, ShuFang Zhang, Xia Wang, Xiangyang An","doi":"10.2147/PGPM.S529276","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of <i>ABCB1</i> C3435T gene polymorphism with hyperglycemia on the risk of major adverse cardiovascular events (MACE) in patients treated with clopidogrel after percutaneous coronary intervention (PCI).</p><p><strong>Patients and methods: </strong>A total of 117 patients were studied, of which 52 developed MACE. We used fluorescence in situ hybridization to detect the genotype of the <i>CYP2C19</i> and <i>ABCB1</i> C3435T loci. Baseline characteristics, fasting blood glucose, and clinical outcomes were collected. Logistic regression was used to analyze factors influencing MACE in PCI patients treated with clopidogrel.</p><p><strong>Results: </strong>There were significant differences between normal and MACE groups in gender, age, history of diabetes mellitus, history of alcohol consumption, fasting blood glucose, <i>ABCB1</i> (CC) with normoglycemia, and <i>ABCB1</i> (CT/TT) combined with hyperglycemia (<i>P</i> < 0.05). <i>ABCB1</i> C3435T genotype (<i>P</i>= 0.024, OR = 5.584, 95% CI 1.258-24.780), age (<i>P</i>= 0.014, OR = 1.073, 95% CI 1.014-1.135), History of hypertension (<i>P</i>= 0.020, OR = 3.144, 95% CI 1.200-8.238) and History of diabetes mellitus (<i>P</i>= 0.030, OR = 3.731, 95% CI 1.135-12.270) were independent MACE risk factors. In patients <75 years, history of hypertension (<i>P</i>= 0.021, OR = 3.151, 95% CI 1.189-8.350) was a risk factor, while the <i>ABCB1</i> (CC) with normoglycaemia (<i>P</i>= 0.023, OR = 0.147, 95% CI 0.028-0.767) was a protective factor.</p><p><strong>Conclusion: </strong>The <i>ABCB1</i> C3435T genotype is an independent risk factor for MACE after PCI with clopidogrel therapy. <i>ABCB1</i> CC combined normoglycemia may protect against MACE in patients <75 years.</p><p><strong>Trial registration: </strong>Registration number: ChiCTR2400082012, Reg Date: 2024-03-19.</p>","PeriodicalId":56015,"journal":{"name":"Pharmacogenomics & Personalized Medicine","volume":"18 ","pages":"209-217"},"PeriodicalIF":1.8000,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396218/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association Between ABCB1 Gene Polymorphism with Hyperglycemia and MACE in Patients Undergoing Clopidogrel Treatment After PCI.\",\"authors\":\"Bo Zhou, Chuanshen Shi, Qike Xu, Yujia Wei, ShuFang Zhang, Xia Wang, Xiangyang An\",\"doi\":\"10.2147/PGPM.S529276\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate the effect of <i>ABCB1</i> C3435T gene polymorphism with hyperglycemia on the risk of major adverse cardiovascular events (MACE) in patients treated with clopidogrel after percutaneous coronary intervention (PCI).</p><p><strong>Patients and methods: </strong>A total of 117 patients were studied, of which 52 developed MACE. We used fluorescence in situ hybridization to detect the genotype of the <i>CYP2C19</i> and <i>ABCB1</i> C3435T loci. Baseline characteristics, fasting blood glucose, and clinical outcomes were collected. Logistic regression was used to analyze factors influencing MACE in PCI patients treated with clopidogrel.</p><p><strong>Results: </strong>There were significant differences between normal and MACE groups in gender, age, history of diabetes mellitus, history of alcohol consumption, fasting blood glucose, <i>ABCB1</i> (CC) with normoglycemia, and <i>ABCB1</i> (CT/TT) combined with hyperglycemia (<i>P</i> < 0.05). <i>ABCB1</i> C3435T genotype (<i>P</i>= 0.024, OR = 5.584, 95% CI 1.258-24.780), age (<i>P</i>= 0.014, OR = 1.073, 95% CI 1.014-1.135), History of hypertension (<i>P</i>= 0.020, OR = 3.144, 95% CI 1.200-8.238) and History of diabetes mellitus (<i>P</i>= 0.030, OR = 3.731, 95% CI 1.135-12.270) were independent MACE risk factors. In patients <75 years, history of hypertension (<i>P</i>= 0.021, OR = 3.151, 95% CI 1.189-8.350) was a risk factor, while the <i>ABCB1</i> (CC) with normoglycaemia (<i>P</i>= 0.023, OR = 0.147, 95% CI 0.028-0.767) was a protective factor.</p><p><strong>Conclusion: </strong>The <i>ABCB1</i> C3435T genotype is an independent risk factor for MACE after PCI with clopidogrel therapy. <i>ABCB1</i> CC combined normoglycemia may protect against MACE in patients <75 years.</p><p><strong>Trial registration: </strong>Registration number: ChiCTR2400082012, Reg Date: 2024-03-19.</p>\",\"PeriodicalId\":56015,\"journal\":{\"name\":\"Pharmacogenomics & Personalized Medicine\",\"volume\":\"18 \",\"pages\":\"209-217\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-08-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396218/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pharmacogenomics & Personalized Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/PGPM.S529276\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pharmacogenomics & Personalized Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/PGPM.S529276","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0
摘要
目的:探讨ABCB1 C3435T基因多态性与高血糖对氯吡格雷经皮冠状动脉介入治疗(PCI)患者发生重大心血管不良事件(MACE)风险的影响。患者和方法:共117例患者,其中52例发生MACE。采用荧光原位杂交技术检测CYP2C19和ABCB1 C3435T基因座的基因型。收集基线特征、空腹血糖和临床结果。采用Logistic回归分析氯吡格雷治疗PCI患者MACE的影响因素。结果:MACE正常组与MACE正常组在性别、年龄、糖尿病史、饮酒史、空腹血糖、ABCB1 (CC)伴正常血糖、ABCB1 (CT/TT)伴高血糖等方面差异均有统计学意义(P < 0.05)。ABCB1 C3435T基因型(P= 0.024, OR = 5.584, 95% CI 1.158 ~ 24.780)、年龄(P= 0.014, OR = 1.073, 95% CI 1.014 ~ 1.135)、高血压史(P= 0.020, OR = 3.144, 95% CI 1.200 ~ 8.238)、糖尿病史(P= 0.030, OR = 3.731, 95% CI 1.135 ~ 12.270)是MACE的独立危险因素。患者中P= 0.021, OR = 3.151, 95% CI 1.189-8.350)为危险因素,而伴有正常血糖的ABCB1 (CC)为保护因素(P= 0.023, OR = 0.147, 95% CI 0.028-0.767)。结论:ABCB1 C3435T基因型是氯吡格雷PCI术后MACE的独立危险因素。ABCB1 CC联合正常血糖可预防MACE患者试验注册号:ChiCTR2400082012,注册日期:2024-03-19。
Association Between ABCB1 Gene Polymorphism with Hyperglycemia and MACE in Patients Undergoing Clopidogrel Treatment After PCI.
Purpose: To evaluate the effect of ABCB1 C3435T gene polymorphism with hyperglycemia on the risk of major adverse cardiovascular events (MACE) in patients treated with clopidogrel after percutaneous coronary intervention (PCI).
Patients and methods: A total of 117 patients were studied, of which 52 developed MACE. We used fluorescence in situ hybridization to detect the genotype of the CYP2C19 and ABCB1 C3435T loci. Baseline characteristics, fasting blood glucose, and clinical outcomes were collected. Logistic regression was used to analyze factors influencing MACE in PCI patients treated with clopidogrel.
Results: There were significant differences between normal and MACE groups in gender, age, history of diabetes mellitus, history of alcohol consumption, fasting blood glucose, ABCB1 (CC) with normoglycemia, and ABCB1 (CT/TT) combined with hyperglycemia (P < 0.05). ABCB1 C3435T genotype (P= 0.024, OR = 5.584, 95% CI 1.258-24.780), age (P= 0.014, OR = 1.073, 95% CI 1.014-1.135), History of hypertension (P= 0.020, OR = 3.144, 95% CI 1.200-8.238) and History of diabetes mellitus (P= 0.030, OR = 3.731, 95% CI 1.135-12.270) were independent MACE risk factors. In patients <75 years, history of hypertension (P= 0.021, OR = 3.151, 95% CI 1.189-8.350) was a risk factor, while the ABCB1 (CC) with normoglycaemia (P= 0.023, OR = 0.147, 95% CI 0.028-0.767) was a protective factor.
Conclusion: The ABCB1 C3435T genotype is an independent risk factor for MACE after PCI with clopidogrel therapy. ABCB1 CC combined normoglycemia may protect against MACE in patients <75 years.
期刊介绍:
Pharmacogenomics and Personalized Medicine is an international, peer-reviewed, open-access journal characterizing the influence of genotype on pharmacology leading to the development of personalized treatment programs and individualized drug selection for improved safety, efficacy and sustainability.
In particular, emphasis will be given to:
Genomic and proteomic profiling
Genetics and drug metabolism
Targeted drug identification and discovery
Optimizing drug selection & dosage based on patient''s genetic profile
Drug related morbidity & mortality intervention
Advanced disease screening and targeted therapeutic intervention
Genetic based vaccine development
Patient satisfaction and preference
Health economic evaluations
Practical and organizational issues in the development and implementation of personalized medicine programs.