Effect of polymorphism of platelet receptors genes P2RY12, ITGB3 and CYP2C19 cytochrome metabolizer enzyme on the platelet activity and efficiency of clopidogrel in patients with stable stenocardia in the Grodno region

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The aim of the study was to assess the distribution of polymorphic variants G681A of the CYP2C19 gene, H1/H2 of the P2RY12 gene, and T1565C of the ITGB3 gene and to study their effect on the platelet activity and clopidogrel efficacy in patients with stable stenocardia living in the Grodno region. The study included 92 patients with stable stenocardia, 89 of them underwent elective percutaneous coronary intervention (PCI), and 93 practically healthy people. The survey data (general clinical, aggregometry, general blood count and platelet indices, and polymerase chain reaction genotyping) were analyzed using the STATISTICA 10.0 software.A high prevalence of carriage of genotypes associated with possible variability in response to clopidogrel therapy was revealed both among patients with stable stenocardia and among practically healthy individuals in the Grodno region. The frequency of occurrence of studying genotypes among patients with stable stanocardia was 23.9 % for the CYP2C19 gene (polymorphic locus G681A), 40.2 % for the P2RY12 gene (polymorphic locus H1/H2), and 31.5 % for the gene ITGB3 (polymorphic locus T1565C). For the group of practically healthy individuals, the distribution of these genotypes was 18.3; 46.2; 37.6 %, respectively. Associations were revealed between the carriage of the 681A allele of the CYP2C19 gene and the H2 haplotype of the P2RY12 gene with high residual platelet reactivity during clopidogrel therapy in patients with stable stenocardia. An association was found between the carriage of the H2 haplotype of the H1/H2 polymorphism of the P2RY12 gene with high platelet MPV values and a higher frequency of large platelets (P-LCR) in patients with stable stenocardia.