[CYP2C19 gene polymorphism in patients with myocardial infarction who use clopidogrel]

Kardiologiia. 2012;52(4):20-4.
[Article in Russian]

Abstract

One of the foundations of the modern treatment of myocardial infarction (MI) is a combination antiplatelet therapy consisting of acetylsalicylic acid (ASA) and clopidogrel. Pharmacodynamic and clinical studies have demonstrated that the polymorphism CYP2C19 (CYP2C19*2 allele) is associated with a reduced antiplatelet effect of clopidogrel and an increase in the incidence of severe cardiovascular complications. The study included 97 patients with MI. Coronary angiography was performed with subsequent standard treatment of MI, including stenting of the infarct-related coronary artery. CYP2C19 polymorphism was determined by polymerase chain reaction. At 6months, outcomes were determined. The frequency of allele CYP2C19*2 was 22.7%. We found statistically insignificant differences in the prevalence of CYP2C19 gene polymorphism in different forms of myocardial infarction. In contrast to the authors, who previously published data on the effect of CYP2C19 gene polymorphism on cardiovascular complications, we found no differences according to genotype. CYP2C19 gene polymorphism does not influence the prognosis for the next six months, if to patient follow medical recommendations, including the regular use of clopidogrel.

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary
  • Aryl Hydrocarbon Hydroxylases / genetics*
  • Aspirin / administration & dosage
  • Aspirin / pharmacokinetics
  • Biotransformation / genetics*
  • Clopidogrel
  • Coronary Angiography
  • Cytochrome P-450 CYP2C19
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / genetics*
  • Myocardial Infarction / therapy
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / pharmacokinetics
  • Polymorphism, Genetic
  • Stents
  • Ticlopidine / administration & dosage
  • Ticlopidine / analogs & derivatives*
  • Ticlopidine / pharmacokinetics
  • Treatment Outcome

Substances

  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Aryl Hydrocarbon Hydroxylases
  • CYP2C19 protein, human
  • Cytochrome P-450 CYP2C19
  • Ticlopidine
  • Aspirin