Objective To analyze the correlation between paraoxonase-1 (PON1) Q192R gene polymorphism and clopidogrel resistance in patients with acute myocardial infarction.
Methods A total of 135 patients with acute myocardial infarction were selected as research objects. All patients were treated with standard clopidogrel for 5 consecutive days and post-discharge for 12 months continuously. After 12 months of medication, the platelet aggregation rate was measured in the hospital. Patients were divided into resistance group (aggregation rate >50%) and sensitive group (≤50%) according to platelet aggregation rate. PON1 Q192R gene polymorphism was detected by fluorescence in situ hybridization.
Results Platelet aggregation was determined in 135 patients with acute myocardial infarction, 103 cases (76.30%) in the sensitive group and 32 cases (23.70%) in the resistance group. The incidence rates of heterozygous and homozygous single nucleotide polymorphisms (SNP) of PON1 Q192R gene distribution in the resistance group were significantly higher than those in the sensitive group (P < 0.05). The incidence of end-point events at one year after operation in the resistance group was significantly higher than that in the sensitive group (P < 0.05). The platelet aggregation rate of adenosine diphosphate (ADP) and the incidence of major adverse cardiovascular events (MACE) in PON1 Q192R wild-type were significantly lower than those in PON1 Q192R mutant (P < 0.05). PON1 Q192R gene mutation and ADP platelet aggregation ratewere risk factors for MACE in patients with acute myocardial infarction (P < 0.05). SNP heterozygous type and SNP homozygous type of PON1 Q192R gene were significantly correlated with clopidogrel resistance (P < 0.05).
Conclusion PON1 Q192R gene polymorphisms has higher correlation with clopidogrel resistance in patients with AMI.
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