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The AKR1D1*36 (rs1872930) Allelic Variant Is Independently Associated With Clopidogrel Treatment Outcome

Aleksandra Kapedanovska-Nestorovska1, Aleksandar J Dimovski1,2, Zoran Sterjev1

  • 1Center for Biomolecular and Pharmaceutical Analysis, Faculty of Pharmacy, University Ss Cyril and Methodius, Skopje, Republic of North Macedonia.

Pharmacogenomics and Personalized Medicine
|November 8, 2019
PubMed

Insights

The AKR1D1*36 allele increases the risk of major adverse cardiovascular and cerebrovascular events (MACCE) in patients treated with clopidogrel, leading to shorter event-free survival.

Area of Science:

  • Pharmacogenomics
  • Cardiovascular Medicine
  • Genetics

Background:

  • Clopidogrel is a widely used antiplatelet medication.
  • Genetic variations can influence clopidogrel's efficacy and patient outcomes.
  • Identifying genetic markers for adverse events is crucial for personalized medicine.

Purpose of the Study:

  • To investigate the association between the AKR1D1*36 (rs1872930) allele and the risk of major adverse cardiovascular and cerebrovascular events (MACCE).
  • To evaluate the impact of this genetic variant on event-free survival in patients receiving clopidogrel therapy.

Main Methods:

  • Observational cohort study of 118 cardiovascular patients on clopidogrel therapy.
  • Kaplan-Meier/Log-rank analysis and multivariable Cox regression were employed.
  • Follow-up duration was a median of 38.5 months.

Main Results:

  • Patients with the AKR1D1*36 allele exhibited significantly shorter event-free survival (HR=2.193, p=0.0155).
  • The AKR1D1*36 allele was confirmed as an independent risk factor for MACCE (HR=2.36).
  • Other independent risk factors identified included previous PCI, history of myocardial infarction, and CYP2C19*2 polymorphism.

Conclusions:

  • The AKR1D1*36 (rs1872930) variant is an independent predictor of increased MACCE risk.
  • This genetic variant is associated with reduced event-free survival in clopidogrel-treated patients.
  • Findings highlight the importance of pharmacogenetic profiling for optimizing clopidogrel therapy.
Abstract

Keywords:
AKR1D1CYP2C19DAPTMACCENorth Macedoniaclopidogrel

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