Allele frequency distribution of CYP2C19*2 allelic variants associated with clopidogrel resistance in cardiac patients

Abstract

Abstract. Drug resistance is a phenomenon that has become a critical issue in medical practice. Such is the case in the response to clopidogrel treatment, which is variable inter-individually and inter-ethnically due to genetic polymorphisms in the cytochrome P40 (CYP) gene. Clopidogrel is an anti-platelet agent administered to cardiac patients in the form of a prodrug, which is further metabolized into an active form by CYP enzymes. There are many allelic variants of the CYP gene that are involved in clopidogrel resistance, of which CYP2C19*2 has been demonstrated to be one of the most significant loss-of-function alleles. In the present study, 100 cardiac patients with percutaneous coronary intervention (PCI) or acute coronary syndrome (ACS) who were undergoing treatment with clopidogrel were selected and the patients were analyzed for CYP2C19*2 allelic variants using an allele-specific primer extension polymerase chain reaction method. The variant amplicons were visualized on gel and validated by Sanger sequencing.

A Remote Assay for Measuring Canine Platelet Activation and the Inhibitory Effects of Antiplatelet Agents

“…Clopidogrel requires cytochrome P450 for activation and polymorphisms convey variable clinical efficacy of some P2Y 12 antagonists . Many alleles have been implicated, causing both gain and loss of function . This is complicated by other medications, which are also substrates for cytochromes, for example, omeprazole .…”

“…37,38 Many alleles have been implicated, causing both gain and loss of function. [39][40][41] This is complicated by other medications, which are also substrates for cytochromes, for example, omeprazole. 42 Dogs receiving clopidogrel and omeprazole had increased concentrations of clopidogrel inactive metabolites although this did not alter platelet activity.…”

Polimorfisme Cyp2c19*2 Terhadap Agregasi Platelet Dan Kejadian Kardiovaskular Pada Pasien Penyakit Jantung Koroner

“…(2,3) Salah satu jenis terapi yang dapat digunakan untuk pasien Penyakit Jantung Koroner (PJK) adalah antiplatelet. Pemberian antiplatelet bertujuan untuk menurunkan agregasi platelet, mencegah terbentuknya trombus pada pembuluh darah, JURNAL ILMIAH MANUNTUNG, 7(1), [21][22][23][24][25][26][27][28][29][30][31]2021 PRIMANITHA RIA UTAMI 22 AKADEMI FARMASI SAMARINDA sekaligus mencegah berkembangnya kerusakan ventrikel jantung yang dapat memicu kejadian kardiovaskular.…”

The Effect of CYP2C19 and Nongenetic Factors on Clopidogrel Responsiveness in the MENA Region: A Systematic Review

“…Figure 1 shows the flowchart of the included studies. Twenty-eight studies were eligible for full-text screening, 6 studies were excluded for studying patients outside the MENA region, 13,[19][20][21][22][23] and 2 papers were excluded because they were reviews. 24,25 The 20 studies reviewed were from 8 different countries, including Egypt, Jordan, Iran, Lebanon, Turkey, Saudi Arabia, Palestine, and Qatar.…”