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<p>The variability of clopidogrel response is due to many factors including polymorphisms affecting <i>CYP2C19</i>. This study aims to assess the impact of the <i>CYP2C19*2(681G &gt; A)</i>, <i>CYP2C19*3(636G &gt; A)</i> and <i>CYP2C19*17(-806&#xa0;C &gt; T)</i> polymorphisms on platelet response to clopidogrel in patients with coronary artery disease. This is a cross-sectional study led on patients treated with clopidogrel (75&#xa0;mg/day for at least seven days). Platelet reactivity was assessed by the VerifyNow<sup>®</sup> P2Y12 test and high on treatment platelet reactivity was defined by a PRU ≥ 208. The genotyping of <i>CYP2C19</i> polymorphisms was performed by PCR- RFLP. The study involved 115 coronary patients with a mean age of 58 ± 10 years. The VerifyNow<sup>®</sup>P2Y12 test showed that 27.8% were resistant to clopidogrel. The genetic study showed that <i>CYP2C19*2(681G &gt; A)</i> is significantly associated with biological resistance to clopidogrel (G vs. A, OR = 4.713 [95% CI: 1.738–12.780]; <i>p</i> = 0.002), while <i>CYP2C19*17(-806&#xa0;C &gt; T)</i> is a protective factor against clopidogrel non-responsiveness (C vs. T, OR = 0.413 [95% CI: 0.174–0.981]; <i>p</i> = 0.02). By classifying patients into extensive (*1/*1: 52%), intermediate (*1/*2: 16%) and ultra-rapid metabolizers (*1/*17;*17/*17: 32%), we found that the type of metabolizer had a significant impact on clopidogrel response (<i>p</i> = 0.001). <i>CYP2C19*2 (681G &gt; A)</i> is significantly associated with biological resistance to clopidogrel while <i>CYP2C19*17(-806&#xa0;C &gt; T)</i> is a protective factor against clopidogrel non-responsiveness.</p>

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Association of Cyp2c19 Genotype with Variability in Clopidogrel Response in Coronary Patients

  • 期刊论文

  • 发表日期：

    2025年10月27日

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  • Farah Yacoub,
  • Saoussen Chouchene,
  • Hajer Foddha,
  • Amani Abderahmene,
  • Rym Dabboubi,
  • Haythem Raddaoui,
  • Maroua Razzek,
  • Rania El Aissi,
  • Rania Elaissi,
  • Mayssa Gaaloul,
  • Taieb Messaoud,
  • Asma Omezzine,
  • Mohsen Hassine

摘要

The variability of clopidogrel response is due to many factors including polymorphisms affecting CYP2C19. This study aims to assess the impact of the CYP2C19*2(681G > A), CYP2C19*3(636G > A) and CYP2C19*17(-806 C > T) polymorphisms on platelet response to clopidogrel in patients with coronary artery disease. This is a cross-sectional study led on patients treated with clopidogrel (75 mg/day for at least seven days). Platelet reactivity was assessed by the VerifyNow® P2Y12 test and high on treatment platelet reactivity was defined by a PRU ≥ 208. The genotyping of CYP2C19 polymorphisms was performed by PCR- RFLP. The study involved 115 coronary patients with a mean age of 58 ± 10 years. The VerifyNow®P2Y12 test showed that 27.8% were resistant to clopidogrel. The genetic study showed that CYP2C19*2(681G > A) is significantly associated with biological resistance to clopidogrel (G vs. A, OR = 4.713 [95% CI: 1.738–12.780]; p = 0.002), while CYP2C19*17(-806 C > T) is a protective factor against clopidogrel non-responsiveness (C vs. T, OR = 0.413 [95% CI: 0.174–0.981]; p = 0.02). By classifying patients into extensive (*1/*1: 52%), intermediate (*1/*2: 16%) and ultra-rapid metabolizers (*1/*17;*17/*17: 32%), we found that the type of metabolizer had a significant impact on clopidogrel response (p = 0.001). CYP2C19*2 (681G > A) is significantly associated with biological resistance to clopidogrel while CYP2C19*17(-806 C > T) is a protective factor against clopidogrel non-responsiveness.