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Clopidogrel Pharmacogenetics in Iranian Patients Undergoing Percutaneous Coronary Intervention

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A Correction to this article was published on 09 August 2018

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Abstract

Clopidogrel is used in patients with coronary syndromes and at risk of thrombotic events or receiving percutaneous coronary intervention (PCI) for reducing heart attack and stroke. Here we present genotype and phenotype study of Iranian patients undergoing PCI treated with clopidogrel during a 6-month period of follow-up; common variants of CYP2C19, CYP3A5, CYP3A4, and ABCB1 genes were determined as well as the patients’ cardiovascular outcomes to find out the effect of these variants individually and in combination. 388 individuals receiving PCI were enrolled in this study. Different pretreatment doses of clopidogrel were prescribed under the interventional cardiologists’ guidance. The patients were followed for a duration of 1 month, and 6 months. Six SNPs were selected for genotyping including CYP2C19*2 (c.681G > A), CYP2C19*3 (c.636G > A), CYP2C19*17 allele (c.−806C > T), ABCB1 (c.3435C > T), CYP3A5 (c.6986A > G), and CYP3A4 (c.1026 + 12G > A). The mean loading dose was 600 mg/day in 267 (68.8%) individuals, 300 mg/day in 121 (31.2%). 8 patients had cardiovascular events such as thrombosis, unstable angina, and non-STEMI. The studied alleles and genotypes were in Hardy–Weinberg equilibrium. None of the SNPs individually were significantly associated with outcome events. Our results indicate that combinations of different alleles of genes are involved in pharmacokinetic variability and joint factors are important; this means that genotyping and analysis of an individual variant may not be as straightforward in risk assessment and pharmacogenetics. This highlights the importance of personalized medicine in risk assessment and treatment.

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Change history

  • 09 August 2018

    The original version of this article unfortunately contained a typo in the co-author name.

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Acknowledgements

We would like to thank the staff of genetic laboratory at Rajaie Hospital. We would like to thank professor Edward Tuddenham for critical reading of the manuscript.

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Authors and Affiliations

  1. Medical Genetics Laboratory, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Valiasr Street, Niyaesh Intersection, Tehran, 1995614331, Iran

    Nejat Mahdieh, Maryam Hoseinimoghaddam, Bahareh Rabbani & Majid Maleki

  2. Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran

    Ahmad Rabbani, Ata Firouzi, Ali Zahedmehr, Sedigheh Saedi, Hamidreza Sanati, Hosseinali Basiri & Feridoun Noohi

  3. Growth and Development Research, Tehran University of Medical Sciences, Tehran, Iran

    Bahareh Rabbani

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  1. Nejat Mahdieh
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Correspondence to Bahareh Rabbani.

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Handling Editor: Dipak K. Dube.

The ​original ​version ​of ​this ​article ​was ​revised: There is a spelling mistake in the 6th author name. The correct name is “Sedigheh Saedi” instead of “Sedigheh Saeidi”.

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Mahdieh, N., Rabbani, A., Firouzi, A. et al. Clopidogrel Pharmacogenetics in Iranian Patients Undergoing Percutaneous Coronary Intervention. Cardiovasc Toxicol 18, 482–491 (2018). https://doi.org/10.1007/s12012-018-9459-x

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