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November 28, 2023Journal of the Pakistan Medical AssociationOpen Access

Cytochrome P-450 CYP2C19 genetic polymorphism and its relation with clopidogrel resistance

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Why the study?

To evaluate the prevalence of the CYP2C19*2 genetic polymorphism in ischaemic heart disease patients and assess its relation to clopidogrel resistance across genotype groups.

Does CYP2C19*2 genetic polymorphism affect clopidogrel resistance in Pakistani patients with ischemic heart disease?

Population

390 ischaemic heart disease patients on clopidogrel therapy

Comparison

Homozygous wild type (*1/*1) vs heterozygous (*1/*2) vs homozygous polymorphic (*2/*2) carriers

Design

Cross-sectional study

Authors

UNUsman NawazMNMudassar NoorAWAkbar Waheed

Discussion

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Overview

The CYP2C19*2 polymorphism is highly prevalent in Pakistani ischemic heart disease patients and is significantly associated with increased clopidogrel resistance.

Structured PICO

Does CYP2C19*2 genetic polymorphism affect clopidogrel resistance in Pakistani patients with ischemic heart disease?

P
Population
390 Pakistani patients with ischemic heart disease (angina, myocardial infarction, or acute coronary syndrome) of either gender, age 16-82 years, taking clopidogrel 75mg/day orally for at least 7 days.
I
Intervention
CYP2C19*2 genotyping (identifying GG, GA, and AA carriers) while on clopidogrel 75mg/day.
C
Comparator
Comparison between different CYP2C19*2 genotype groups (homozygous wild type GG vs. heterozygous GA vs. homozygous polymorphic AA).
O
Outcome
Clopidogrel resistance, defined as ≥50% platelet aggregation measured by light transmission aggregometry.surrogate

The CYP2C19*2 polymorphism is highly prevalent in Pakistani ischemic heart disease patients and is significantly associated with increased clopidogrel resistance.

Limitations

  • Focused on only one SNP (CYP2C19*2) due to financial constraints, despite other SNPs being related to clopidogrel resistance.
  • Used light transmission aggregometer because it was the only available method, rather than more advanced methods of platelet aggregation studies.

Cite This Study

Nawaz et al. (2023) studied this question.

synapsesocial.com/papers/6a7f76e2ac3f8fa531a55390https://doi.org/10.47391/jpma.8025
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