Bo Zhou,1,* Chuanshen Shi,2,* Qike Xu,1 Yujia Wei,3 ShuFang Zhang,1 Xia Wang,1 Xiangyang An1 

1Clinical Pharmacy, The Affiliated Taian City Central Hospital of Qingdao University, Taian, Shandong, People’s Republic of China; 2Clinical Pharmacy, Taian Public Health Medical Centre, Taian, Shandong, People’s Republic of China; 3Department of Pain, The First People’s Hospital of Baiyin, Baiyin, Gansu, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Xiangyang An, The Affiliated Taian City Central Hospital of Qingdao University, No. 29 Longtan Road Taian, Shandong, People’s Republic of China, Email zxyyaxy@163.com

Purpose: To evaluate the effect of ABCB1 C3435T gene polymorphism with hyperglycemia on the risk of major adverse cardiovascular events (MACE) in patients treated with clopidogrel after percutaneous coronary intervention (PCI).
Patients and Methods: A total of 117 patients were studied, of which 52 developed MACE. We used fluorescence in situ hybridization to detect the genotype of the CYP2C19 and ABCB1 C3435T loci. Baseline characteristics, fasting blood glucose, and clinical outcomes were collected. Logistic regression was used to analyze factors influencing MACE in PCI patients treated with clopidogrel.
Results: There were significant differences between normal and MACE groups in gender, age, history of diabetes mellitus, history of alcohol consumption, fasting blood glucose, ABCB1 (CC) with normoglycemia, and ABCB1 (CT/TT) combined with hyperglycemia (P < 0.05). ABCB1 C3435T genotype (P= 0.024, OR = 5.584, 95% CI 1.258– 24.780), age (P= 0.014, OR = 1.073, 95% CI 1.014– 1.135), History of hypertension (P= 0.020, OR = 3.144, 95% CI 1.200– 8.238) and History of diabetes mellitus (P= 0.030, OR = 3.731, 95% CI 1.135– 12.270) were independent MACE risk factors. In patients < 75 years, history of hypertension (P= 0.021, OR = 3.151, 95% CI 1.189– 8.350) was a risk factor, while the ABCB1 (CC) with normoglycaemia (P= 0.023, OR = 0.147, 95% CI 0.028– 0.767) was a protective factor.
Conclusion: The ABCB1 C3435T genotype is an independent risk factor for MACE after PCI with clopidogrel therapy. ABCB1 CC combined normoglycemia may protect against MACE in patients < 75 years.
Trial Registration: Registration number: ChiCTR2400082012, Reg Date: 2024-03-19.

Keywords: ABCB1 C3435T, coronary artery disease, PCI, genetic polymorphism, major adverse cardiac events