Análisis farmacogenético de CYP2C19 y su impacto en la respuesta a clopidogrel en pacientes con síndrome coronario agudo atendidos en MEDERI: Un enfoque genético-poblacional

Clopidogrel is the most widely used antiplatelet drug in patients with acute coronary syndrome (ACS) for the prevention of atherothrombotic events. This drug is an inactive prodrug that requires several biotransformation processes in the body to become an active metabolite. The active form of clopidogrel binds to the P2Y12 receptor and inhibits adenosine diphosphate (ADP)-stimulated platelet aggregation. Importantly, several genes are involved in the pharmacokinetic, pharmacodynamic and transport response of the drug. A large interindividual variability in therapeutic outcome has also been identified, attributed in part to polymorphisms in these genes. Different studies have estimated that the heritability of the clopidogrel response phenotype is 70%, indicating an important influence of genetic variance, which is potentially responsible for thrombotic events, bleeding and even death in patients treated with the antiplatelet drug. This study analyzed the entire coding and regulatory region of CYP2C9, which allowed us to determine new molecular variants of interest and the distribution of frequencies in our population.