Systematic Review of the Relationship Between CYP2C19 Gene Polymorphism and Platelet Aggregation Inhibition Rate in Chinese Patients Taking Clopidogrel for Coronary Artery Disease

OBJECTIVE To systematically evaluate the correlation between CYP2C19 gene polymorphism and platelet aggregation inhibition rate detected by thromboelastography in Chinese patients taking clopidogrel for coronary artery disease. METHODS Databases of PubMed, Embase, Cochrane's Library, CNKI, CQVIP, Wanfang and CBM were systematically searched for Chinese patients taking clopidogrel and simultaneously with CYP2C19 gene polymorphism and detected by thromboelastography. Meta-analyses of CYP2C19 gene polymorphism and platelet inhibition rate and the rate of clopidogrel resistance were performed with RevMan 5.3. RESULTS Twenty-five articles involving 4 967 patients were included for meta-analyses. For the platelet aggregation inhibition rate, extensive metabolizer was significant higher than intermediate metabolizerMD=9.17, 95%CI(3.68, 14.65), P=0.001 and poor metabolizerMD=20.63, 95%CI(11.32, 29.94), P<0.000 1, and intermediate metabolizer was significant higher than poor metabolizerMD=11.63, 95%CI(5.60, 17.67), P=0.000 2. Meanwhile, for the rate of clopidogrel resistance, extensive metabolizer was significant lower than intermediate metabolizerRR=0.60, 95%CI(0.53, 0.67), P<0.000 01 and poor metabolizerRR=0.36, 95%CI(0.28, 0.47), P<0.000 01, and intermediate metabolizer was significant lower than poor metabolizerRR=0.59, 95%CI(0.48, 0.73), P<0.000 01. CONCLUSION Although there is a significant correlation between the CYP2C19 gene polymorphism and the platelet aggregation inhibition rate detected by thromboelastography in Chinese patients taking clopidogrel for coronary artery disease, clinicians shall make the right interpretation with the CYP2C19 gene polymorphism and(or) the platelet aggregation inhibition rate, and clinical decision shall be made in combination with patient's specific conditions.