Association between P2Y12 platelet receptor(C34T and G52T) polymorphisms and risk of cardiovascular events in coronaryheart disease with clopidogrel in Chinese

Objective Recent data have implicated a haplotype of P2Y12 platelet receptor,as potential risk determinant for atherothrombosis.We wanted to investigate whether the platelet P2Y12 receptor polymorphims affected long-term prognosis of Chinese patients who were treated with clopidogrel after percutaneous coronary intervention(PCI) .Methods Between January 1,2008 and December 31,2009,268 patients who received PCI and were exposed to clopidogrel treatment for almost 12 months,were enrolled in Fu Wai Hospital and underwent P2Y12(G52T and C34T) determination.Follow-up was 12 months.The primary endpoint was a composite of death,myocardial infarction,urgent coronary revascularization and stent thrombosis occurring during exposure to clopidogrel.Results The patients were grouped H1 /H1(n = 195) and H2 carriers(H1 /H2 and H2 /H2,n = 73) by P2Y12 G52T genetype.Baseline characteristics were balanced between the two groups,except the proportion of H1 /H1 is higher than H2 carriers in two vessel lesions (P 0.05) .The combined end points also occurred more frequently in H2 carriers than in H1 /H1(12.3% vs.5.1% ,P 0.05 ) .There were no significant difference between two groups with myocardial infarction,stent thrombosis,urgent coronary revascularization and death (P 0.05) .During the following time,cumulative survival of H2 carriers was lower than H1(HR = 2.543,95% CI: 1.033 ～ 6.259,P = 0.042) .The patients were also grouped CC genotype(n = 174) and T carriers(CT and TT,n = 94) by P2Y12 C34T genetype.Baseline characteristics were balanced between the two groups.There were no significant difference between two groups with the combined end points and cumulative survival(HR = 1.081,95% CI: 0.426 ～ 2.746,P = 0.870) .Conclusions P2Y12 platelet receptor H2 haplotype(G52T) is a major determinant of prognosis in Chinese patients with cardiac heart disease(CHD) who are receiving clopidogrel treatment after PCI.But there is not a strong association between C34T and an increased risk of cardiovascular events in patients with CHD receiving clopidogrel.