CO-EXISTENCE OF CYP2C19*1/*2 AND ABCB1C.3435 CT GENOTYPE HAS A POTENTIAL IMPACT ON CLINICAL OUTCOME IN CAD PATIENTS TREATED WITH CLOPIDOGREL
Nestorovska KA, Naumovska Z, Staninova Stojovska M, Sterjev Z, Dimovski A, Suturkova Lj
*Corresponding Author: Aleksandra Kapedanovska Nestorovska, PhD, Faculty of Pharmacy, Ss. Cyril and Methodius University in Skopje, Skopje, RN Macedonia, Mother Theresa str 47, 1000 Skopje, R. North Macedonia, Email address: alka@ff.ukim.edu.mk
page: 35
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Abstract
Clopidogrel, is a standard treatment in the prevention
of major adverse cardiovascular events (MACE) in patients
with coronary artery disease (CAD). Clopidogrel response
is highly variable, mainly due to the presence of polymor-
phisms in the genes involved in drug metabolism. The aim
of this study was to evaluate the association between the
presence of the ABCB1 C3435T and CYP2C19*2 poly-
morphism and the clinical outcome in patients with CAD
treated with clopidogrel. A total of 96 patients with CAD
were included in the study. Genomic DNA from peripheral
blood was extracted from all patients with standard phenol/
chloroform protocol. The genotyping was performed by
Real-Time PCR using TagMan assays. The frequency of
the reduced-function allele, in both genes, was higher in
patients with negative outcome (36.36% vs 21.15%). A
negative clinical outcome and an increased risk for MACE
was observed in patients with concomitant inheritance of
the CYP2C19 *1/*2 and ABCB1 CT genotype vs patients
with other genotypes (22.73% vs 9.62%; OR 3.455; 95%
CI= [0.936-12.743], p=0.05722. A trend towards higher risk
of MACE was also noted in carriers of the CYP2C19*1/*1
and ABCB1 CC/CT genotype. Our results support the data
on the association of the CYP2C19 *2 alone, or in combina-
tion with the ABCB1 C polymorphism with the increased
risk of MACE. The results also indicate that the presence
of ABCB1 C343T polymorphism might be potentially con-
sidered as independent predictor of MACE in patients on
clopidogrel. However, these results are preliminary and
should be confirmed on a larger number of patients.
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