Abstract
BackgroundAcute coronary syndrome (ACS) has become a vital disease with high mortality in the Uygur populations. Clopidogrel plays an important role in reducing the risk of recurrent cardiovascular events after ACS; however, it is a prodrug that requires biotransformation by cytochrome P450 (CYP450).ObjectivesTo determine the effect of genetic polymorphisms in CYP2C19*2, *3, and *17, and along with clinical, demographic factors, on variation in response to clinical outcomes in Uygur patients.MethodsA total of 351 patients with ACS were treated with clopidogrel and aspirin for at least 12 months; we recorded major adverse cardiovascular events (MACE) or bleeding within 1 year. Multivariable logistic regression analyses were carried out to identify factors associated with MACE or bleeding.ResultsWe analyze risk factors include age, BMI (body mass index), smoking, alcohol intake, NSTEMI (non-ST-segment elevation myocardial infarction), hypertension, dyslipidemia, concomitant medication, CYP2C19*2 carriers, CYP2C19*17 carriers and metabolizer phenotype. CYP2C19*2 carriers had an odds of having MACE of 2.51 (95% CI: 1.534–4.09) compared with noncarriers (P < .001). However, no factors were significantly associated with bleeding (P > 0.05).ConclusionThe CYP2C19*2 gene polymorphism contributes to the risk of MACE in dual clopidogrel—treated Uygur population with ACS with or without PCI (percutaneous coronary intervention). These data may provide valuable insights into the genetic polymorphisms affecting clopidogrel metabolism among minority groups in China.
Highlights
Acute coronary syndrome (ACS) has become a vital disease with high mortality in the Uygur populations
The CYP2C19*2 gene polymorphism contributes to the risk of major adverse cardiovascular events (MACE) in dual clopidogrel—treated Uygur population with ACS with or without percutaneous coronary intervention (PCI)
Clinical characteristics A total of 351 Uygur ACS patients were successfully enrolled in the study who were treated with clopidogrel and aspirin during 1 year of clinical follow-up
Summary
Acute coronary syndrome (ACS) has become a vital disease with high mortality in the Uygur populations. Clopidogrel plays an important role in reducing the risk of recurrent cardiovascular events after ACS; it is a prodrug that requires biotransformation by cytochrome P450 (CYP450). Acute coronary syndromes (ACS) are triggered by fissuring or rupture of an atheromatous plaque in the coronary arterial wall. This stimulates a thrombotic response causing variable obstruction to flow in the coronary arterial lumen with downstream ischaemic myocardial injury [1]. Clopidogrel is a prodrug requiring cytochrome P450 (CYP) for biotransformation into its active thiol metabolite. The most important of these is cytochrome P450, family 2, subfamily C, polypeptide 19 (CYP2C19), which metabolize clopidogrel to its active form [3]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
