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- Title
Association of genetic variant and platelet function in patients undergoing neuroendovascular stenting.
- Authors
Xin-Gang Li; Ning Ma; Shu-Sen Sun; Zhe Xu; Wei Li; Yong-Jun Wang; Xin Yang; Zhong-Rong Miao; Zhi-Gang Zhao; Li, Xin-Gang; Ma, Ning; Sun, Shu-Sen; Xu, Zhe; Li, Wei; Wang, Yong-Jun; Yang, Xin; Miao, Zhong-Rong; Zhao, Zhi-Gang
- Abstract
<bold>Introduction: </bold>The risk of recurrent ischaemic events is related to platelet function, which is often assessed by thromboelastography (TEG). TEG has high interindividual variability.<bold>Objective: </bold>To identify causal variants associated with TEG parameters in patients who receive aspirin and clopidogrel after intra- or extracranial stenting.<bold>Methods: </bold>Patients who underwent stenting for extracranial or intracranial stenosis (70-99%) were recruited into the study. Blood samples were obtained for TEG to assess the platelet function before stenting. Aspirin- and clopidogrel-related genetic polymorphisms were determined by the MassARRAY method. Minor allele frequency and Hardy-Weinberg equilibrium (HWE) tests and linkage disequilibrium (LD) analysis were carried out. The influences of genetic polymorphism on TEG parameters were analysed by linear regression.<bold>Results: </bold>A total of 249 patients were included in this study. Twenty-two selected single nucleotide polymorphisms (SNPs) were genotyped, and no significant deviation from HWE was found for any SNP in the study patients. Four SNPs-rs2104543, rs12772169, rs1998591 and rs1042194-within CYP2C18 were in high LD, and the genetic polymorphisms had a significant impact on the TEG parameters maximal clot strength (MAThrombin) and ADP-induced platelet-fibrin clot strength (MAADP). Patients who carried the loss-of-function CYP2C19*2 (rs4244285) allele were also at risk of increased MAThrombin and MAADP.<bold>Conclusions: </bold>Testing for these polymorphisms may be valuable in the identification of patients at high risk of recurrent ischaemic events. Alternative treatments may be considered for these high-risk patients.<bold>Trial Registration Number: </bold>NCT01925872.
- Subjects
HUMAN genetic variation; BLOOD platelets; SURGICAL stents; ENDOVASCULAR surgery; NEUROSCIENCES; CEREBRAL ischemia treatment; STROKE treatment; ALLELES; ASPIRIN; CEREBRAL ischemia; GENETIC polymorphisms; GENETICS; STROKE; THROMBELASTOGRAPHY; TICLOPIDINE; DISEASE relapse; PLATELET aggregation inhibitors; GENOTYPES
- Publication
Postgraduate Medical Journal, 2017, Vol 93, Issue 1103, p555
- ISSN
0032-5473
- Publication type
journal article
- DOI
10.1136/postgradmedj-2016-134745