Frequency of CYP2C19 Gene Polymorphism and Its Impact on Clinical Outcome among Ischemic Heart Disease Patients Taking Clopidogrel after Percutaneous Coronary Intervention

Abstract

Introduction : Clopidogrel is an oral thienopyridine derivative is capable of inhibiting platelet activation. Clopidogrel is a prodrug that is converted into an active drug by hepatic cytochrome CYP2C19, CYP2C19*2 and CYP2C19*3 polymorphic alleles are considered to be important loss-of-function alleles resulting in diminished response to clopidogrel. Aim of the work :our study aimed to detect frequency of CYP2C19 gene polymorphisms and its impact on clinical outcome in ischemic heart disease patients treated by clopidogrel. Patients and methods: blood samples were collected from 102 ischemic heart disease patients and the gene frequency was determined by PCR and all patients were followed by clinical assessment and invasive and non-invasive cardiac investigations. Results: frequency of CYP2C19*1 was 50%, CYP2C19*2 was 15% and CYP2C19*3 was 1%, CYP2C19*17 was 34%, patients with recurrent ischemic attacks 37patients (35.8%),from those patients, 10 patients were normal metabolizer (27%),and 27 patients were abnormal metabolizers(73%) with p-value 0.047 to myocardial infarction and 0.020 to unstable angina. Conclusion: A significance relation was found between CYP2C19 polymorphism and recurrent ischemic attacks in this study and multicenter studies are required to confirm this results.