Clopidogrel utilization in patients with coronary artery disease and diabetes mellitus: should we determine CYP2C19*2 genotype? View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-12

AUTHORS

Saoussen Chouchene, Rym Dabboubi, Haythem Raddaoui, Hela Abroug, Khaldoun Ben Hamda, Sondess Hadj Fredj, Fatma Abderrazak, Mayssa Gaaloul, Marwa Rezek, Fadoua Neffeti, Ilhem Hellara, Mouna Sassi, Linda Khefacha, Asma Sriha, Semir Nouira, Mohamed Fadhel Najjar, Faouzi Maatouk, Taieb Messaoud, Mohsen Hassine

ABSTRACT

PURPOSE: Clopidogrel non-responsiveness is multifactorial; several genetic and non-genetic factors may contribute to impaired platelet inhibition. The goal of this study is to determine the effect of the cytochrome P450 CYP2C19*2 polymorphism on the platelet response to clopidogrel in patients with and without diabetes mellitus (DM). METHODS: We conducted an observational study in patients with coronary artery disease and consequent exposure to clopidogrel therapy (75 mg/day for at least 7 consecutive days). We have analyzed two groups of patients: group I (DM patients) and group II (non-diabetes mellitus patients). Platelet reactivity was assessed by the VerifyNow P2Y12 assay and high on clopidogrel platelet reactivity (HPR) was defined as P2Y12 reaction units (PRU) ≥ 208. Genotyping for CYP2C19*2 polymorphism was performed by PCR-RFLP. RESULTS: We have included 150 subjects (76 DM and 74 non-diabetes mellitus patients). The carriage of CYP2C19*2 allele, in DM patients, was significantly associated to HPR (odds ratio (OR) 4.437, 95% confidence interval (CI) 1.134 to 17.359; p = 0.032). Furthermore, 8.4% of the variability in percent inhibition by clopidogrel could be attributed to CYP2C19*2 carrier status. However, in non-diabetes mellitus patients, there was no significant difference in platelet response to clopidogrel according to the presence or absence of CYP2C19*2 allele carriage (OR 1.260, 95% CI 0.288 to 5.522; p = 0.759). CONCLUSIONS: Our study suggests that the carriage of CYP2C19*2 polymorphism, in DM patients, might be a potential predictor of persisting HPR in these high-risk individuals. TRIAL REGISTRATION: Clinical Trials.gov NCT03373552 (Registered 13 December 2017). More... »

PAGES

1567-1574

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00228-018-2530-5

DOI

http://dx.doi.org/10.1007/s00228-018-2530-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1105974996

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30073432


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