Hemorrhagic cerebral complications on the background of therapy with clopidogrel in patients with ischemic stroke with CYP2C19*17 polymorphous carriage: a clinical case

Abstract

Objective. To demonstrate on a clinical example the importance of conducting pharmacogenetic testing in patients with ischemic stroke receiving clopidogrel in order to identify the polymorphic carriage of CYP2C19*17 (C806T, rs12248560). Materials and methods. A clinical and laboratory examination of 121 patients with ischemic stroke was carried out, the CYP2C19*17 polymorphism (C806T, rs12248560) associated with an increase in the effectiveness of clopidogrel, low residual platelet reactivity, and an increased risk of bleeding was determined. Carriage of polymorphic markers was determined by real-time polymerase chain reaction. Results and conclusion. In two patients (1.7 %), carriers of polymorphic markers CYP2C19*17, hemorrhagic cerebrovascular complications were detected on the background of clopidogrel. Gastrointestinal bleeding, as well as other complications of antiplatelet therapy, are not registered in practice