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ASSA14-03-27 Association between insulin receptor substrate-1 genotypes and clopidogrel resistance in patients with type 2 diabetes mellitus and coronary artery disease
  1. D Zhang,
  2. X Zhang,
  3. L Dan,
  4. Y Han
  1. Department of Cardiology, Institute of Cardiovascular Research of People’s Liberation Army, Shenyang General Hospital, Shenyang, Liaoning 110840, China

Abstract

Backgroud To investigate the possible association between insulin receptor substrate-1 (IRS-1) genotypes and clopidogrel resistance (CR) in Chinese patients with type 2 diabetes mellitus and coronary artery disease.

Methods A total of 690 hospitalised patients with type 2 diabetes mellitus and coronary artery disease in General Hospital of Shenyang command between April 2011 and April 2013 were enrolled. The residual platelet aggregation rate (RPA)induced by 20 μmol/L of adenosine diphosphate (ADP) was detected by optical nephelometry. Clopidogrel resistance was defined by RPA ≥70%. All the participants were divided into CR group and NCR group by RPA. The association between IRS-1 genetic variant and platelet function was assessed in patients with type 2 diabetes mellitus and coronary artery disease.

Results There were 419 patients in NCR group and 271 patients in CR group. The frequency of GG genotype of rs13431554 was significantly lower in NCR than CR patients (2.9% vs 6.7%, p = 0.032). The GG genotype was more commonly associated with high platelet activity in study patient. There was no significant difference in allele frequencies between CR and NCR group.

Conclusion Type 2 DM and CAD patients who are carriers of the GG genotype of the rs13431554 of the IRS-1 gene have a hyperreactive platelet phenotype and associated with clopidogrel resistance.

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