Influence of ABCB1 C3435T Genotype on Clinical Cardiovascular Outcomes in Coronary Artery Disease Patients on Clopidogrel Treatment
MOJ Drug Design Development & Therapy
Clopidogrel has been used as a gold standard (alone or in association with aspirin) to prevent vascular complications in atherothrombotic patients undergoing PCI, and as a long-term prevention of cardiovascular events. The drug is subject to efflux via P-glycoprotein (encoded by the ABCB1 gen, also known as MDR1). The ABCB1 C3435T polymorphism may be associated with altered drug metabolism, efficacy and clinical outcome. The aim of this study was to evaluate the influence of ABCB1 C3435T
... e on clinical cardiovascular outcomes in coronary artery disease patients on clopidogrel treatment. Methods: The study included a total of 203 subjects, of which 107 healthy volunteers and 96 patients diagnosed with coronary artery disease on treatment with clopidogrel from the Special Hospital for Surgical Diseases "Filip II". The genotyping of both the control group and the patient group was performed with Real-Time PCR based on the allelic discri¬mi¬na¬tion method. Statistical analysis was performed using SPSS software. The genotype distri¬butions were assessed for the Hardy-Weinberg equilibrium (HWE) with χ2 test. Results: The C3435T allele and genotype frequency distribution testing in the patient group showed that the polymorphism is not associated with a risk of atherosclerotic cardiovascular disease (ACD) in the Macedonian population (p>0.05). A higher C-risk allele frequency was found in the subgroup of patients with negative outcome after treatment, compared to the subgroup of patients with positive outcome (0.5568 vs 0.4904; OR=1.306 TC; p=0.35855). The same trend was observed when following the C3435T allele and genotype distribution in the subgroup of patients with normal CYP2C19 genetic status (CYP2C19*1/*1) (0.6400 vs 0.4868; OR=1.874 TC; p=0.09105). Conclusion: The results indicate that the ABCB1 C3435T polymorphism is an independent and complementary genetic factor that affects the outcome of clopidogrel treatment, but requires further research and a bigger study population. Citation: Vavlukis A, Nestorovska AK, Sterjev Z, et al. Influence of ABCB1 C3435T genotype on clinical cardiovascular outcomes in coronary artery disease patients on Clopidogrel treatment. MOJ Drug Des Develop Ther. 2017;1(2):40-45.