Co-Existence of CYP2C19*1/*2 and ABCB1c.3435 CT Genotype has a Potential Impact on Clinical Outcome in CAD Patients Treated with Clopidogrel

Parameter	Total number of patients (N=96)	Patients with positive outcome (N=52)	Patients with negative outcome (N=44)
Demographic characteristics
Age	60.42±9.05	60.64±9.19	60.16±9.22
Male	59 (61.46%)	33 (63.46%)	26 (59.09%)
Clinical characteristics
History of myocardial infarction	27 (28.13%)	10 (19.23%)	17 (38.64%)
History of diabetes	48 (50%)	24 (46.15)	24 (54.54%)
NYHA classification^*
Class I	22 (22.92%)	15 (28.85%)	7 (15.91%)
Class II	31 (32.29%)	14 (26.92%)	17 (38.64%)
Class III	41 (42.71%)	22 (42.31%)	19 (43.18%)
Class IV	2 (2.08)	1 (1.92%)	1 (2.27%)
Diagnosis^**
105–06	4 (4.17%)	3 (5.77%)	1 (2.27%)
120–23	54 (56.25%)	32 (61.54%)	22 (50%)
125	17 (17.71%)	8 (15.38%)	9 (20.45%)
135	3 (3.13%)	1 (1.92%)	3 (6.82%)
165–66, 170–74	17 (17.71%)	8 (15.38%)	9 (20.45%)

[i] NYHA classification^*

Class I No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation or dyspnea.

Class II Slight limitation of physical activity. Comfortable at rest but ordinary physical activity results in fatigue, palpitation or dyspnea.

Class III Marked limitation of physical activity. Comfortable at rest but less than ordinary activity results in fatigue, palpitation or dyspnea.

Class IV Unable to carry out any physical activity without discomfort. Symptoms at rest. If any physical activity is undertaken, discomfort is increased.

[ii] Diagnosis^**

105–06 mitral and aortal stenosis (rheumatic etiology)

120–23 angina, acute myocardial infarction, complications after myocardial infarction

125 – atherosclerotic cardiovascular disease

135 – aortal stenosis (nonrheumatic etiology)

165–66, 170–74 atherosclerosis, aortal aneurism, other peripheral vascular diseases, arterial embolism and thrombosis

Table 2.

Genotype frequencies of ABCB1 and CYP2C19 in patients treated with clopidogrel

*CYP2C19*	*ABCB1*	Positive outcome N=52	Observed Frequency (%)	HWE Frequency (%)	Negative outcome N=44	Frequencies (%)	Expected Frequencies (%)	OR	95%	p value
Genotype		Positive outcome N=52	Observed Frequency (%)	HWE Frequency (%)	Negative outcome N=44	Frequencies (%)	Expected Frequencies (%)	OR	95%	p value
ABCB1 CC homozygotes
^1/^1	CC	9	17.31	17.7	11	4.84	5.4	1.00
^1/^2	CC	3	5.77	5.0	2	4.55	3.4	0.545	0.074–4.008	0.54819
^2/^2	CC	0	0	0.4	0	0	0.6	0.826	0.015–45.693	1.0000
ABCB1 CT heterozygotes
^1/^1	CT	19	36.54	32.9	11	25	11.1	1.00
^1/^2	CT	5	9.62	16.8	10	22.73	9.7	3.455	0.936–12.743	0.05722
^2/^2	CT	3	5.77	2.2	2	4.55	2.1	1.152	0.166–7.990	0.88644
ABCB1 TT homozygotes
^1/^1	TT	10	19.23	19.6	4	9.09	8.6	1.00
^1/^2	TT	3	5.77	5.1	3	6.82	7.8	2.500	0.346–18.039	0.35720
^2/^2	TT	0	0	0.3	1	2.27	1.8	7.00	0.237–206.784	0.14323

Table 3.

Allelic distribution of the ABCB1 and CYP2C19 polymorphisms in CAD patients treated with clopidogrel

Allele	Patients with positive outcome (N=52)	Patients with negative outcome (N=44)
Allele	number of patients
CYP2C19^1/ ABCB1* C	36	34
CYP2C19^1/ ABCB1* T	37	28
CYP2C19^2/ ABCB1* C	11	14
CYP2C19^2/ ABCB1* T	11	16

Allelic distribution of *ABCB1* and *CYP2C19* in patients with CAD treated with clopidogrel

Table 4.

Phenotype frequencies of CYP2C19 and ABCB1 in clopidogrel treated patients

Phenotype/Metabolizer	Patients with positive outcome (N=52)			Patients with negative outcome (N=44)			OR	p
Phenotype/Metabolizer	N	Observed Frequency (%)	HWE Frequency (%)	N	Observed Frequency (%)	HWE Frequency (%)	OR	p
Normal^*	9	0.1731	0.1872	2	0.0454	0.1673	1.000
Intermediate^**	27	0.5192	0.4909	32	0.7272	0.4834	5.333	0.02805
Poor^***	16	0.3077	0.3218	10	0.2272	0.3491	2.812	0.22842

* Carrier of CYP2C19^*1/^*1/ ABCB1 CC genetic polymorphism

** Carrier of CYP2C19^*1/^*1/ ABCB1 CT genetic polymorphism

CYP2C19^*1/^*1/ ABCB1 CT genetic polymorphism

CYP2C19^*1/^*2/ ABCB1 CT genetic polymorphism

CYP2C19^*1/^*2/ ABCB1 CC genetic polymorphism

*** Carrier of CYP2C19^*2/^*2/ ABCB1 CC genetic polymorphism

CYP2C19^*2/^*2/ ABCB1 CT genetic polymorphism

CYP2C19^*1/^*1/ ABCB1 TT genetic polymorphism

CYP2C19^*1/^*2/ ABCB1 TT genetic polymorphism

CYP2C19^*2/^*2/ ABCB1 TT genetic polymorphism

References

Authors

Metrics

Articles in this issue

DOI: https://doi.org/10.2478/bjmg-2023-0023 | Journal eISSN: 2199-5761 (formerly 1311-0160) | Journal ISSN: 1311-0160

Journal RSS Feed

Language: English

Page range: 35 - 40

Published on: Mar 12, 2024

Published by: Macedonian Academy of Sciences and Arts

In partnership with: Paradigm Publishing Services

Keywords:

ABCB1,

clopidogrel,

CYP2C19,

coronary artery disease,

P-glycoprotein,

pharmacogenetics

Related subjects:

Medicine,

Basic medical science,

Basic medical science, other

© 2024 KA Nestorovska, Z Naumovska, M Staninova Stojovska, Z Sterjev, A Dimovski, Lj Suturkova, published by Macedonian Academy of Sciences and Arts
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Volume 26 (2023): Issue 2 (December 2023)

Co-Existence of CYP2C191/2 and ABCB1c.3435 CT Genotype has a Potential Impact on Clinical Outcome in CAD Patients Treated with Clopidogrel

Figures & Tables

Table 1.

Table 2.

Table 3.

Figure 1.

Table 4.

Paradigm

My account