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CYP2C19 polymorphism frequency in Russian patients in Central Russia and Siberia with acute coronary syndrome

Karin B Mirzaev1, Elena M Zelenskaya2, Olga L Barbarash3

  • 1Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Moscow.

Pharmacogenomics and Personalized Medicine
|April 27, 2017
PubMed

Insights

Genetic variants in CYP2C19 influence clopidogrel response in Russian acute coronary syndrome patients. Frequencies of poor metabolizer alleles and the CYP2C19*17 variant varied significantly across Siberian regions.

Area of Science:

  • Pharmacogenomics
  • Cardiovascular Medicine
  • Genetics

Background:

  • Clopidogrel is a key antiplatelet medication for acute coronary syndrome (ACS).
  • Patient response to clopidogrel is significantly influenced by genetic variations in the CYP2C19 enzyme.
  • CYP2C19 poor metabolizer (PM) alleles reduce clopidogrel efficacy, while the CYP2C19*17 variant may increase bleeding risk.

Purpose of the Study:

  • To determine the frequencies of CYP2C19*2, *3 (poor metabolizer) and CYP2C19*17 (rapid metabolizer) variants in Russian ACS patients.
  • To investigate regional differences in these allele frequencies across Siberia and Moscow.

Main Methods:

  • Genotyping of 512 ACS patients treated with coronary stenting.
  • Patient recruitment from Central, Eastern, and Northern Siberia, and the Moscow region.
  • Analysis of allele frequencies for CYP2C19*2, *3, and *17 variants.

Main Results:

  • 16% to 27.5% of patients carried at least one CYP2C19 PM allele, impacting clopidogrel metabolism.
  • The CYP2C19*17 allele frequency ranged from 15.4% to 33.3% across regions.
  • Statistically significant differences in CYP2C19*3 allele frequency were observed between Eastern and Central Siberian populations (p=0.001).

Conclusions:

  • Significant variations in CYP2C19 allele frequencies exist between Eastern and Central Siberia.
  • These genetic differences may be attributed to the substantial Buryat population in Eastern Siberia.
  • Understanding regional genetic variations is crucial for optimizing clopidogrel therapy in ACS patients.
Abstract

Keywords:
P2Y12 receptor inhibitorsclopidogrel resistancedual antiplatelet therapy

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