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The correlation between platelet responsiveness to clopidogrel and CYP2C19 polymorphism in patients with peripheral

N M El-Khodary1, A M El-Behery, N A El-Askary

  • 1Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt. nohamahmoud_55@hotmail.com.

European Review for Medical and Pharmacological Sciences
|October 18, 2021
PubMed

Insights

Clopidogrel resistance, affecting 22% of Egyptians studied, is linked to the CYP2C19*2 gene, obesity, and diabetes. These factors are crucial for predicting patient response to clopidogrel therapy.

Area of Science:

  • Pharmacogenomics
  • Cardiovascular Medicine
  • Clinical Chemistry

Background:

  • High platelet reactivity post-clopidogrel treatment is observed in patients undergoing vascular interventions.
  • Understanding genetic and clinical predictors of clopidogrel response is vital for optimizing treatment.

Purpose of the Study:

  • To determine the frequency of the CYP2C19*2 genetic polymorphism in an Egyptian population.
  • To assess the contribution of CYP2C19*2 and other clinical factors to clopidogrel resistance.

Main Methods:

  • Platelet aggregation analysis was performed on 50 patients receiving clopidogrel.
  • Single-nucleotide polymorphism (SNP) genotyping for CYP2C19*2 was conducted using quantitative real-time polymerase chain reaction (QRT-PCR).

Main Results:

  • Clopidogrel resistance was found in 22% of the Egyptian cohort.
  • CYP2C19*2 genotype, high body mass index (BMI), diabetes, high fasting blood glucose (FBG), and high glycosylated hemoglobin (HbA1c) were associated with resistance.
  • Multivariate analysis identified CYP2C19*2 genotype and high BMI as the strongest predictors of clopidogrel resistance.

Conclusions:

  • Clopidogrel resistance in peripheral vascular disease patients is associated with the CYP2C19*2 allele, obesity, and diabetes.
  • These factors warrant consideration before initiating clopidogrel therapy to personalize treatment strategies.
Abstract

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