Comparison of Adjunctive Naoxintong versus Clopidogrel in Volunteers with the CYP2C19*2 Gene Mutation Accompanied with Qi Deficiency and Blood Stasis Constitution

摘要

This study was to determine the impact of adjunctive Buchang Naoxintong Jiaonang (BNJ) to clopidogrel on volunteers with the CYP2C19*2 gene mutation accompanied with qi deficiency and blood stasis (QDBS) constitution. Eighteen males with QDBS constitution were selected, who were 6 CYP2C19*1/*1, 6 CYP2C19*1/*2, and 6 CYP2C19*2/*2, and signed informed consent. Results showed that the maximal platelet aggregation (Aggmax) and 5 min aggregation (Agglate) with 5-μmol/L ADP in three different CYP2C19*2 genotypes were significantly decreased after any drug therapy compared with corresponding baseline measurements (all valuesP<.05). But percent inhibitions of Aggmaxand Agglate(IPAs) in CYP2C19*2/*2 genotype at 4 hours, 24 hours, 3 days, and 7 days after clopidogrel administration were all the lowest among three CYP2C19*2 genotypes (P<.01), and IPAs in CYP2C19*1/*2 genotype were between CYP2C19*1/*1 and CYP2C19*2/*2. IPAs had no significant difference among three different CYP2C19*2 genotypes after BNJ or adjunctive BNJ. In addition, changes of CD62P, PAC1, and sCD40L were similar to changes of ADP-induced platelet aggregation in three different CYP2C19*2 genotypes. Conclusion was that adjunctive BNJ to clopidogrel can enhance the antiplatelet effect in volunteers with the CYP2C19*2 gene mutation.