Expression of Variability of the Cyp2c19*2 Gene in Patients With Acute Myocardial Infarction From a South American Hospital and Its Future Relevance in the Interaction Between Genetics and Cardiology

Abstract

Introduction : Some Polymorphisms of the CYP2C19 gene are associated with a decrease in the activity of the enzyme they encode , being the case of CYP2C19*2 in causing a lower generation of active metabolite of clopidogrel and therefore a low or null antiplatelet action depending on the genotype present . . Antiplatelet therapy , mainly clopidogrel , is considered essential treatment in the management of acute coronary syndromes (ACS). Target : The frequency of the CYPC19*2 polymorphism , identified as relevant in resistance to clopidogrel , is unknown in the population of this part of South America . Methods : A descriptive , observational and cross-sectional study was designed to determine the frequency of the CYP2C19*2 allele in patients with ACS admitted to a South American hospital during the period between 2015-2016, being the first study to determine polymorphism in our population . fifty-nine adults patients diagnosed with ACS were included , 48 male (81.3%) and 11 female (18.7%), aged between 54 and 86 years . The genotype for the CYP2C19 gene was determined through the PCRRFLP ( Restriction Fragments Length Polymorphism ) technique from DNA extracted desde peripheral blood . Results : The allelic frequency of the CYP2C19*2 polymorphism was 28.5%. Three subgroups of metabolizers were characterized : extensive (*1/*1) 40 (67.8%), intermediate (*1/*2) 17 (28.9%) and poor (*2/*2) 2 (3.3%). Conclusions : This high number of carriers of the CYP2C19*2 polymorphism in the context of ACS is relevant due to its association with a lower responsiveness to clopidogrel and the possible involvement in the choice of antiplatelet therapy , for which characterization studies are required . most appropriate to identify the best therapeutic strategies in our populations through pharmacogenomics .