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Genetic and Nongenetic Factors Affecting Clopidogrel Response in the Egyptian Population

B M Khalil1, M H Shahin2, M H M Solayman2,3

  • 1Department of Biochemistry, Faculty of Pharmacy, Misr International University, Cairo, Egypt.

Clinical and Translational Science
|January 13, 2016
PubMed

Insights

Genetic factors, specifically CYP2C19 loss-of-function alleles, along with age and body mass index, increase the risk of major adverse cardiac events in Egyptians treated with clopidogrel.

Area of Science:

  • Pharmacogenetics
  • Cardiology
  • Genetics

Background:

  • Aspirin and clopidogrel are standard antiplatelet therapies.
  • Despite treatment, major adverse cardiac events (MACE) remain a concern.
  • Individual response to clopidogrel varies significantly.

Purpose of the Study:

  • To investigate genetic and non-genetic factors influencing clopidogrel response in Egyptians.
  • To identify predictors of MACE in patients receiving clopidogrel therapy.

Main Methods:

  • Genotyping of 190 Egyptian patients with acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI) for CYP2C19, CES1, and ABCB1 variants.
  • Analysis of associations between genetic variants, non-genetic factors (age, BMI), and MACE incidence.
  • Logistic regression modeling to determine significant predictors of MACE.

Main Results:

  • Carriers of CYP2C19 loss-of-function (LOF) alleles had a 2.52-fold increased risk of MACE.
  • CYP2C19 LOF variants, older age, and higher BMI were significantly associated with MACE.
  • P-values: CYP2C19 LOF (0.011), age (0.032), BMI (0.039).

Conclusions:

  • CYP2C19 genetic variants are significant predictors of clopidogrel response and MACE risk in Egyptians.
  • Age and body mass index also play a crucial role in clopidogrel treatment outcomes.
  • These findings highlight the importance of personalized medicine in antiplatelet therapy.

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