Clopidogrel Response in Acute Coronary Syndrome Patients With Cyp2y12*2 and Cyp2y12*3 Polymorphisms

Aim. This study aimed to look at the characteristics of the P2Y12 reactivity unit (PRU) in 30 Minang acute coronary syndrome (ACS) patients in Dr. M. Djamil Hospital, Padang, Indonesia. Material and methods. This research was a cross-sectional study conducted in September 2016. The effectiveness of clopidogrel on platelet reactivity was identified through examination of PRU values using VerifyNow® with a cut-off point of 208. From the PRU values, it can be classified whether patients were resistant or responsive. Results. This study shows that 30 patients with ACS who received clopidogrel, 24 patients (80%) were male and 6 female patients (20%). Hypertension was the greatest risk factor for the coronary arterial disease. A total of 11 patients (36,77%) were resistant and 19 patients (63,33%) were responsive to clopidogrel. About 46,67% patients were extensive metabolizers. PRU of these patients were lower than intermediate and poor metabolizers. Conclusion. ACS patients with functional loss of CYP2C19 activity have lower platelet activity when treated with clopidogrel. Routine CYP2C19 and PRU testing may be warranted. Further research is needed with a larger number of patients to investigate the pharmacogenetic profile of CYP2C19 and the cause of clopidogrel resistance in Minang patients.