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ORIGINAL ARTICLE
Year : 2021  |  Volume : 10  |  Issue : 3  |  Page : 80-84

Clopidogrel resistance in cardiovascular disease patients and its association with gene polymorphisms: A pilot study


1 Department of Cardiology, Super-Speciality Hospital, SIMS, Shimoga, Karnataka, India
2 Multidisciplinary Research Unit (MRU), Shimoga Institute of Medical Sciences, Shimoga, Karnataka, India
3 Department of Biochemistry, Shimoga Institute of Medical Sciences, Shimoga, Karnataka, India
4 General Medicine, McGann Teaching District Hospital, SIMS-Shimoga, Karnataka, India

Correspondence Address:
Dr. S Parameshwara
Department of Cardiology, Super-Speciality Hospital, SIMS, Shimoga, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcpc.jcpc_71_20

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Aims: To determine the genotypic and allelic frequencies of multidrug resistance protein 1 (MDR1), CYP2C19, and P2Y12 gene and their polymorphisms in the Shimoga population who admitted for treatment in McGann teaching district hospital-Shimoga Institute of Medical Sciences (SIMS), Shimoga. Materials and Methods: It is a cross-sectional study that was conducted in McGann teaching district hospital, SIMS, Shimoga. Patients who were admitted to the Intensive coronary care unit due to cardiovascular disease (CVD) were recruited for the study. Sociodemographic data with venous blood samples (5 ml) were collected along with informed consent. Genotyping of the MDR1, CYP2C19, and P2Y12 polymorphisms were done using the polymerase chain reaction (PCR) restriction fragment length polymorphism method. Descriptive and inferential statistics were done using the Statistical Package for the Social Sciences software. The genotypic and allelic frequency was calculated using the Hardy-Weinberg equilibrium. Results: Out of 40 CVD cases, 60% were male and 40% were female and the mean age was found to be 57.13 ± 11.57 years. The percentage of the obese group was more compared to other groups of body mass index. Risk factors such as diabetes, hypertension, food custom, smoking, and tobacco consumption were not significant while alcohol consumption was seen to be significant among the study population at a 5% level of significance. The genotypic frequencies for a heterozygous and mutant type of MDR1 (C3435T) and CYP2C19*2 (G681A) were found to be 35%, 2.5%, 57.5%, and 5%, respectively. Whereas the gene polymorphism of CYP2C19*3 and P2Y12 was not observed in the present study population. Conclusions: This is the first gene polymorphism study with respect to clopidogrel resistance in the Shimoga population. We have demonstrated the presence of polymorphism in the MDR1 and CYP2C19 genes in this study population. A further elaborate study should be conducted for a better understanding of genetic with nongenetic factors involved in poor response toward clopidogrel drug using a large population.


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