Key result
Poor CYP2C19 metabolism is linked to ~212% higher recurrent MI risk in British-South Asians on clopidogrel.
Why the study?
Studies assessing the relationship between CYP2C19 genotype polymorphisms and clinical efficacy have not included South Asian populations.
Does CYP2C19 metabolizer status associate with recurrent myocardial infarction in British-South Asians treated with clopidogrel?
Cross-Sectional (n=697)
Yes
Does CYP2C19 metabolizer status associate with recurrent myocardial infarction in British-South Asians treated with clopidogrel?
CYP2C19 metabolizer status is associated with recurrent myocardial infarction in British-South Asians treated with clopidogrel, suggesting a role for pharmacogenomic-driven prescribing in this population.
May warrant caution with clopidogrel in poor metabolizers; leaves open genotype-guided trials in British-South Asians.
Background: and their relationship with clinical efficacy have not included South Asian populations. Objectives: genotype polymorphisms in a British-South Asian population and correlate these with recurrent myocardial infarction risk in participants prescribed clopidogrel. Methods: diplotypes were assessed using array data. Multivariable logistic regression was used to test for association between genetically inferred CYP2C19 metabolizer status and recurrent myocardial infarction, controlling for known cardiovascular disease risk factors, percutaneous coronary intervention, age, sex, and population stratification. Conclusions: A pharmacogenomic-driven approach to clopidogrel prescribing has the potential to impact significantly on clinical management and outcomes in individuals of Bangladeshi and Pakistani ancestry.
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Magavern et al. (2023) conducted a cross-sectional in Acute myocardial infarction (n=697). CYP2C19 poor metabolizer genotype vs. Normal and rapid CYP2C19 metabolizers was evaluated on Recurrent myocardial infarction (OR 3.12, 95% CI 1.18-8.10, p=0.019). Poor CYP2C19 metabolizers of British-South Asian ancestry prescribed clopidogrel had a significantly higher risk of recurrent myocardial infarction (OR 3.12) compared to normal metabolizers.
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