What question did this study set out to answer?

Determine the prevalence of MDR1, CYP2C19, and P2Y12 gene polymorphisms in an Indian cohort and evaluate their functional impact on clopidogrel response.

February 24, 2013Indian Heart JournalOpen Access

Polymorphisms of MDR1, CYP2C19 and P2Y12 genes in Indian population: Effects on clopidogrel response

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Why the study?

Do genetic polymorphisms of MDR1, CYP2C19, and P2Y12 affect clopidogrel response in Indian patients with acute myocardial infarction?

Population

102 healthy individuals and 26 clopidogrel-naïve acute myocardial infarction patients from an Indian…

Comparison

Clopidogrel vs Wild type genotypes of MDR1, CYP2C19, and P2Y12

Design

Cohort

Follow-up

6 days

Authors

KSKavita ShaliaSir H.N. Reliance Foundation Hospital and Research Centre VSVinod K. ShahThe University of Texas Southwestern Medical Center PPPoonam PawarSir H.N. Reliance Foundation Hospital and Research Centre

Discussion

Member takes

Implication

May suggest caution with clopidogrel in Indian AMI patients carrying variants; hypothesis-generating and should not change practice.

Key Points

Determine the prevalence of MDR1, CYP2C19, and P2Y12 gene polymorphisms in an Indian cohort and evaluate their functional impact on clopidogrel response.
Screened 102 healthy individuals for polymorphism prevalence and evaluated clopidogrel response in 26 clopidogrel-naïve acute myocardial infarction patients selected from 100 cases.
Administered a 300 mg loading dose followed by 75 mg daily, measuring ADP-induced platelet aggregation inhibition at baseline, 24 hours, and 6 days post-treatment.
Genotyped participants using PCR-RFLP for MDR1 C3435T and P2Y12 i-T744C, multiplex PCR for CYP2C19*2 and CYP2C19*3, and nested PCR for CYP2C19*17.
Observed allele frequencies of 0.524 for MDR1 3435T, 0.352 for CYP2C19*2 (681A), 0.088 for P2Y12 i-744C, and 0.897 for wild-type CYP2C19*17 (C806), while CYP2C19*3 was not detected.
Showed a qualitative trend toward impaired inhibition of platelet aggregation at 24 hours in carriers of CYP2C19*2 and P2Y12 i-T744C variant alleles compared to wild-type genotypes.

Structured PICO

Do genetic polymorphisms of MDR1, CYP2C19, and P2Y12 affect clopidogrel response in Indian patients with acute myocardial infarction?

Population

102 healthy individuals and 26 clopidogrel-naïve acute myocardial infarction (AMI) patients (screened from 100 AMI cases) from an Indian population

Intervention

Clopidogrel (300 mg loading dose, followed by 75 mg per day)

Comparator

Wild type genotypes of MDR1, CYP2C19, and P2Y12

Outcome

Clopidogrel response assessed by ADP-induced platelet aggregation and platelet aggregation inhibition (PAI) at 24 hours and 6 dayssurrogate

Variant genotypes of CYP2C19*2 and P2Y12 i-T744C may be associated with a trend toward reduced early antiplatelet response to clopidogrel in the Indian population.

Cite This Study

Shalia et al. (2013) studied this question.

synapsesocial.com/papers/6a73739c30bc69be694e5da1 https://doi.org/10.1016/j.ihj.2013.02.012

Topics

Dual antiplatelet therapy

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Polymorphisms of MDR1, CYP2C19 and P2Y12 genes in Indian population: Effects on clopidogrel response

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Polymorphisms of MDR1, CYP2C19 and P2Y12 genes in Indian population: Effects on clopidogrel response

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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