Evaluation of clopidogrel response variability and identification of the CYP2C19 polymorphism in Mexican patients

Abstract

Response to the clopidogrel loading dose showed a wide variability among patients with 40% responding to the drug according to previously established cut-off values. Our results showed that 3.9% of patients show the AA genotype. To our knowledge, this is the first study involving clopidogrel response by flow citometry and genotype typification in Mexican Mestizo population.

Asociación del polimorfismo CYP2C19*2 con resistencia a clopidogrel en pacientes con alto riesgo cardiovascular en el noreste de México

“…The allele CYP2C19*2 was present in 25.5% of the patients, with a 3.9% of homozygous genotype among patients. This finding is in agreement with a previous study performed in a sample of 51 Mexican mestizo patients from the central region of Mexico with a 17% genetic frequency and 3.9% of the patients having A/A in a homozygous fashion 12 .…”

“…According to the results of the aggregometry, 46% of the patients were classified as good responders, 27.5% showed of 20-40% of the P2Y12 blocking effect, and 26.5% were classified as poor responders. This observation agrees with the reported by Viveros et al, 2016, where 40% of the patients were good responders while 60% of the patients were non-responders 12 . Most of the patients (98.6%) with the G/G genotype presented PRU levels < 234 were classified as responders.…”

Advances in biotechnology: Genomics and genome editing

“…A glimpse of the potential value of this approach comes from drug response analyses, of pharmacogenomic relevance, where for example, 15% of US citizens fail to respond to the widely prescribed clopidrogel (Plavix®) being unable to metabolise the pro-drug form into an active form used to prevent heart attacks and strokes. For a drug with global sales which reached a high of $9.9Bn in 2011, this represents a huge wasted resource, both in financial and risk terms, leading to increased numbers of heart attacks and strokes amongst unidentified non-responders (11), for which the Cytochrome P450 variant CYP 2C19 is a reliable indicator (12). 'DNA App Store' type applications of consumer genomics will allow digitised genomic information to be accessed by any interested software developer, using a 'sequence once, query often' model (9).…”