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Association of ABCB1 and CYP2C19 polymorphisms with major adverse cardiovascular complications in patients taking

Lubna Q Khasawneh1, Mais N Alqasrawi1, Zeina N Al-Mahayri2

  • 1Department of Genetics and Genomics, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.

Frontiers in Cardiovascular Medicine
|July 9, 2026
PubMed

Insights

Common ABCB1 gene variants did not significantly impact major adverse cardiovascular events (MACE) in acute coronary syndrome (ACS) patients treated with clopidogrel. These findings suggest limited utility for ABCB1 genotyping in predicting clopidogrel response in this population.

Area of Science:

  • Pharmacogenomics
  • Cardiovascular Medicine
  • Genetics

Background:

  • Genetic variations influence drug response, impacting clopidogrel efficacy in acute coronary syndrome (ACS) patients.
  • While CYP2C19 variants are linked to reduced clopidogrel efficacy, the role of ABCB1 polymorphisms remains debated.
  • This study investigates ABCB1 and CYP2C19 variants' association with major adverse cardiovascular events (MACE) in an ACS cohort from the UAE.

Purpose of the Study:

  • To evaluate the association between ABCB1 and CYP2C19 genetic variants and MACE in ACS patients treated with clopidogrel.
  • To determine the clinical utility of ABCB1 polymorphisms in predicting clopidogrel response and patient outcomes.
  • To analyze the impact of specific gene variants on cardiovascular event risk within a United Arab Emirates population.

Main Methods:

  • Retrospective cohort study of 174 ACS patients receiving clopidogrel.
  • Genotyping of ABCB1 (rs1045642, rs2032582, rs1128503) and CYP2C19 (*2, *3) variants using real-time PCR TaqMan assays.
  • Statistical analysis including genotype, carrier status, dominant/recessive models, and multivariable logistic regression to assess 1-year MACE outcomes.

Main Results:

  • No significant correlation was found between ABCB1 variants and MACE across different genetic models (p > 0.05).
  • CYP2C19*2 showed a trend towards increased MACE risk in the dominant model (RR=1.41), while CYP2C19*3 was not significantly associated with outcomes.
  • Multivariable analysis indicated age as the only factor with a non-significant trend toward higher risk.

Conclusions:

  • Common ABCB1 variants are not significantly associated with MACE in UAE-based ACS patients treated with clopidogrel.
  • ABCB1 variants did not emerge as predictors of clinical outcomes in multivariate analysis.
  • The current findings suggest limited clinical utility of ABCB1 genotyping for predicting clopidogrel response in this patient group.
Abstract

Keywords:
ABCB1CYP2C19MACEUnited Arab Emiratesclopidogrel

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