ASSOCIATION OF SNP <i>CYP2C19</i> AND CLINICAL PARAMETERS IN RUSSIAN AND BURYAT PATIENTS AFTER TAKING CLOPIDOGREL AFTER CORONARY STENTING

Abstract

Background . Clopidogrel is often used in patients undergoing coronary stenting for acute coronary syndrome. However, the CYP2C19 variants rs4244285(*2), rs4986893 (*3) affect the metabolism of clopidogrel. These alleles occur with different frequencies in patients of different nationalities, so the clopidogrel efficacy may differ in ethnic groups living in Russia. Objective . to assess the associations between genetic determinants of the risk of thrombotic complications during clopidogrel treatment and the clinical characteristics of Buryat and Russian patients, in order to search for personalized informative prognosis markers. Design and methods . The study included 142 Buryat and 150 Russian patients undergoing coronary stent placement for acute coronary syndrome. All patients received clopidogrel. Patients were stratified by the presence of CYP2C19*2 , CYP2C19*3 alleles. In all patients efficacy endpoints were assessed, as well as corresponding therapy. Results . In Buryat patients CYP2C19*3 allele was significantly more common (11,6 % versus 1,3 %, p < 0,001) than in Russian. In Buryat patients, recurrence of anginal pain during exercise was associated with the CYP2C19*3 and/ or CYP2C19*2 genotypes (p = 0,015), as well as with the taking omeprazole (p = 0.015). In Russian patients, efficacy endpoints in clopidogrel treatment were associated with the presence of CYP2C19*2 and/or CYP2C19*3 alleles (p = 0.036). Conclusion . The presence of minor CYP2C19*3 and CYP2C19*2 alleles, along with the reports of recurrence of anginal pain during moderate and light exercise in Buryat patients may be considered as a prognostic sign of thrombotic complications.