Key result
The CES1 S75N T allele (CT + TT genotype) was associated with a significantly lower risk of cerebrovascular events (OR 0.31) and acute myocardial infarction (OR 0.37) compared to the CC genotype.
Why the study?
Does the CES1 S75N (rs2307240) genotype affect the clinical outcomes of clopidogrel therapy in acute coronary syndrome patients?
Cohort (n=851)
Single-blind
Yes
Does the CES1 S75N (rs2307240) genotype affect the clinical outcomes of clopidogrel therapy in acute coronary syndrome patients?
Odds Ratio: 0.31 (95% CI 0.18–0.53)
Absolute Event Rate: 4.8% vs 14%
p-value: p=<0.001
The CES1 S75N variant is significantly associated with improved clinical outcomes in ACS patients receiving clopidogrel, suggesting a potential role for pharmacogenetic testing in antiplatelet therapy.
Supports CES1 S75N as potential clopidogrel modifier in ACS; hypothesis-generating and requires prospective validation before guiding therapy.
Carboxylesterase 1 (CES1) hydrolyzes the prodrug clopidogrel to an inactive carboxylic acid metabolite. The effects of CES1 S75N (rs2307240,C>T) on clopidogrel response among 851 acute coronary syndrome patients who came from the north, central and south of China were studied. The occurrence ratios of each endpoint in the CC group were significantly higher than in the CT + TT group for cerebrovascular events (14% vs 4.8%, p < 0.001, OR = 0.31), acute myocardial infarction (15.1% vs 6.1%, p < 0.001, OR = 0.37) and unstable angina (62.8% vs 37.7%, p < 0.001, OR = 0.36). The results showed that there was a significant association between CES1 S75N (rs2307240) and the outcome of clopidogrel therapy. Moreover, the frequency of the T allele of rs2307240 in acute coronary syndrome patients (MAF = 0.22) was more than four times higher than that in the general public (MAF = 0.05).
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Xiao et al. (2017) conducted a cohort in Acute coronary syndrome (n=851). CES1 S75N CT or TT genotype vs. CES1 S75N CC genotype was evaluated on Cerebrovascular events (OR 0.31, 95% CI 0.18 to 0.53, p=<0.001). The CES1 S75N T allele (CT + TT genotype) was associated with a significantly lower risk of cerebrovascular events (OR 0.31) and acute myocardial infarction (OR 0.37) compared to the CC genotype.
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