Body Weight,Cyp2c19, Andp2y12receptor Polymorphisms Relate To Clopidogrel Resistance In A Cohort Of Chinese Ischemic Stroke Patients With Aspirin Intolerance

Purpose Dual antiplatelet therapy (DAT) with clopidogrel and aspirin is not suitable for clopidogrel resistance (CR) patients with aspirin intolerance. To investigate the prevalence of CR in patients with aspirin intolerance after ischemic stroke (IS) and to assess the relationship between CR andCYP2C19,P2Y12 receptorgenotypes in patients with aspirin intolerance after IS. Methods We enrolled 126 IS patients with aspirin intolerance from Han Chinese in Shangqiu from January 2016 to November 2018. All IS patients with aspirin intolerance were treated with clopidogrel for 7 days. Adenosine diphosphate-induced platelet inhibition rate was measured by thrombelastography (TEG) mapping assay. The SNPs CYP2C19*2,CYP2C19*3, andP2Y12 receptor(52 G >T) were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Binary logistic regression analyses were performed using SPSS version 20.0. Results The prevalence of CR in patients with aspirin intolerance after IS was approximately 31.0%. Multivariate regression analysis showed that body weight (OR 1.091 (95% CI 1.031-1.155),p= 0.003),CYP2C19phenotype intermediate metabolizer (IM) (OR 3.820 (95% CI 1.021-14.288),p= 0.046), andCYP2C19phenotype poor metabolizer (PM) (OR 14.481 (95% CI 2.791-75.129),p= 0.001) significantly increased the risk of CR andP2Y12 receptors(52 G >T) (OR 3.498 [95% CI 1.251-9.784],p= 0.017) increased the risk of CR. Conclusions The patients with high body weight, theCYP2C19phenotypes, andP2Y12 receptor(52 G >T) variant alleles are at risk of CR during clopidogrel treatment in Chinese IS patients with aspirin intolerance. The higher body weight and relevant polymorphisms may help to predict CR in Chinese IS patients with aspirin intolerance.