CLINICAL SIGNIFICANCE OF GENE CYP2C19 POLYMORPHISM IN STEMI PATIENTS (DATA FROM THE KEMEROVO REGISTRY OF THE ACUTE CORONARY SYNDROME)

DOI: https://doi.org/None

Kochergina A.M., Kashtalap V.V., Gordeeva L.A., Kochergin N.A., Barbarash O.L.

Aim is to evaluate distribution and clinical significance of gene CYP2C19 polymorfism in ST-segment elevation myocardial infarction (STEMI) patients. Materials and methods. A total of 159 patients were encluded in this study. All of them underwent primary PCI. According to CYP2C19 inheritance, patients were divided into two groups: «poor» metabolizers and «normal» metabolizers. Results. Poor metabolizing genotype was found in 20 patients (12,57%): CYP2C19*2 (rs4244285) – in 18 cases, а CYP2C19 *3 (rs4986893) – in 2 cases. Both groups were matched by age, gender, diabetes, active smoking. Hospital mortality rate was the same in both groups. Stent thrombosis occurred in patient with normal metabolizers subgroup. Conclusion. The accepted data give no insurance that both resistance clopidogrel is widely spread among STEMI patients in Kemerovo and it provides any clinical impact on STEMI complications and outcomes. Allele CYP2C19 * 3 is the most widely distributed among people of Asian descent, therefore, in the sample presented by Caucasians, this allele is expected to occur extremely rare
Keywords: 
pharmacogenetics, clopidogrel, myocardial infarction

Список литературы: 
  1. Antman E.M., Anbe D.T., Armstrong P.W. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of patients with acute myocardial infarction). J. Am. Coll. Cardiol. 2004; 44: 1–211.
  2. Knaue`r N.Yu., Lifshic G.I., Voronina E.N., Koleda N.V., Gus`kova E.V. Informativnost` geneticheskih markerov dlya optimizacii personalizirovannoy terapii klopidogrelom. Kardiologiya. 2013; 8: 72–5. [Knaujer N.Ju., Lifshic G.I., Voronina E.N., Koleda Informativeness of Genetic Factors for Optimization of Personalized Therapy With Clopidogrel. Kardiologiya. 2013; 8: 72–5 (in Russian)]
  3. Mirzaev K.B., Sychev D.A., Andreev D.A. E`tnicheskie osobennosti v Rossiyskoy Federacii polimorfizma gena CYP2C19, associirovannogo s narusheniem otveta na klopidogrel. Molekulyarnaya medicina. 2014; 1: 13–21. [Mirzaev K.B., Sychev D.A., Andreev D.A. Ethnic differences of the CYP2C19 gene polymorphism associated with the violation of the response to clopidogrel in the Russian Federation. Molekuljarnaja medicina. 2014; 1: 13–21 (in Russian)]
  4. Mirzaev K.B., Sychev D.A., Karkishhenko V.N., Grachev A.V., Knyazeva G.P., Kazakov R.E., Karasev A.V. Chastota polimorfnyh markerov CYP2C19*2, CYP2C19*3, CYP2C19*17 sredi russkoy populyacii i sravnenie rasprostranennosti CYP2C19*2 u pacientov s ishemicheskoy bolezn`yu serdca, poluchayushhih terapiyu klopidogrelem, i zdorovyh dobrovol`cev. Biomedicina. 2013; 1 (1): 117–22. [Mirzaev K.B., Sychev D.A., Karkishhenko V.N., Grachev A.V., Knjazeva G.P., Kazakov R.E., Karasjov A.V. CYP2C19*2, CYP2C19*3, CYP2C19*17 allele and genotype frequencies in clopidogrel-treated patients with coronary heart disease from the Russian population. Biomedicina. 2013; 1 (1): 117–22 (in Russian)]
  5. Galyavich A.S., Valeeva D.D., Minnetdinov R.Sh., Arhipova A.A., Ahmetov I.I., Galyavi R.A. Polimorfizm gena CYP2C19 u bol`nyh infarktom miokarda, primenyayushhih klopidogrel. Kardiologiya. 2012; 4: 20–5. [Galjavich A.S., Valeeva D.D., Minnetdinov R.Sh., Arhipova A.A., Ahmetov I.I., Galjavi R.A. CYP2C19 Gene Polymorphism in Patients With Myocardial Infarction Who Use Clopidogrel. Kardiologiya. 2012; 4: 20–5 (in Russian)]
  6. Lifshic G.I., Aparcin K.A. Prospektivnoe mnogocentrovoe nablyudatel`noe issledovanie PROTOKOL: Personalizirovannaya terapiya klopidogrelom pri stentirovanii po povodu Ostrogo Koronarnogo sindroma s uchetom geneticheskih polimorfizmov. Kachestvennaya klinicheskaya praktika. 2015; 1: 78–86. [Lifshits G.I., Apartsin K.A. Prospective multicenter observational the personalized therapy with clopidogrel for stenting in acute coronary syndrome regarding the genetic polymorphisms (PROTOCOL) study. Kachestvennaja klinicheskaja praktika. 2015; 1: 78–86 (in Russian)]
  7. Giusti B., Gori A.M., Marcucci R., Saracini C., Sestini I., Paniccia R. Relation of cytochrome P450 2C19 loss-of-function polymorphism to occurrence of drug-eluting coronary stent thrombosis. Am. J. Cardiol. 2009; 103 (6): 806–11. Epub 2009. Jan 24