THE CYP2C19*2 (G681A, rs4244285), CYP2C19*3 (G636A, rs4986893) POLYMORPHISMS ASSOCIATED WITH RESISTANCE TO CLOPIDOGREL IN PATIENTS WITH ACS IN THE YAKUT AND RUSSIAN ETHNIC GROUPS

Abstract

Introduction. The aim of this study to determine the prevalence of CYP2C19 alleles, associated with the risk of resistance to clopidogrel and the development of thrombotic complications in patients with the acute coronary syndrome (ACS) from Russian and Yakut ethnic groups.

Materials and methods. The study included 411 patients (64 ± 8.5 years) with ACS receiving clopidogrel. 143 patients were Russians (84 men and 59 women) and 268 patients - Yakuts (153 men and 115 women). Genotyping of CYP2C19*2, CYP2C19*3 polymorphisms was performed by using polymerase real-time chain reaction.

Results. Distribution of alleles and genotypes in both ethnic groups complies with Hardy - Weinberg Equilibrium (CYP2C19*2: Yakuts - χ² = 0,7, p = 0,008; Russians - χ² = 5,78, p = 0,99; CYP2C9*3: Yakuts - χ² = 0,45; p = 0,5; Russians - χ² = 0,19; p = 0,66). The CYP2C19*2 allele frequency in the Yakut ethnic group was higher than in the Russians: 17,53% vs 8,39%; p = 0,0001. No statistically significant difference was found in frequency of CYP2C19*3 in Yakuts and Russians with ACS: 3,92% vs 3,5%; p = 0,76.

Conclusions. Frequency distribution of CYP2C19*2 of polymorphisms associated with resistance to clopidogrel and thrombotic complications was higher in Yakut patients with ACS compared with Russian patients (17,53% vs 8,39%, p = 0.0001). The results of the present study may be helpful for developing guidelines for CYPC19 genotype-directed antiplatelet therapy in Yakut patients with ACS.