Journal
PHARMACOGENOMICS
Volume 13, Issue 5, Pages 533-542Publisher
FUTURE MEDICINE LTD
DOI: 10.2217/PGS.12.24
Keywords
Asian clopidogrel; CYP2C19; metabolism; pharmacogenetics; PON1
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Funding
- National Medical Research Council (Singapore) [NIG09May023, NMRC/CSA/028/2010]
- Cardiovascular Research Institute (Singapore)
- Opto Systems Pte Ltd (Singapore)
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Aim, materials & methods: We investigated the functional significance of CYP2C19*2, *3, *17 and PON1 Q192R SNPs in 89 consecutive Asian patients on clopidogrel treatment and the prevalence of functionally significant polymorphisms among 300 Chinese, Malays and Asian Indians. Results: Both CYP2C19 loss-of-function alleles (*2 or *3) were associated with higher platelet reactivity while the CYP2C19 gain-of-function allele (*17) had lower platelet reactivity. For PON1, the median PRI was not significantly different between the QQ, QR and RR groups. The allele frequencies of CYP2C19*2, CYP2C19*3 and CYP2C19*17 were 0.280, 0.065 and 0.010 (rare) for Chinese, 0.310, 0.050 and 0.025 for Malays, and 0.375, 0.010 (rare) and 0.165 for Indians, respectively. Conclusion: Our data suggest that genotyping studies to investigate clopidogrel response should include CYP2C19*2 and *3 but not *17 polymorphisms in Chinese, and CYP2C19*2 and *17 polymorphisms but not *3 in Indians. All three polymorphisms should preferably be genotyped in Malays.
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