Personalization of clopidogrel therapy based on genetic polymorphism analysis: clinical implications.

Abstract

Objective: This study aimed to evaluate the impact of gene polymorphisms on clopidogrel metabolism and to use this analysis to inform treatment strategy for a population in southern Anhui of China.

Methods: The research was conducted from 2019 to 2022, aincluding 430 patients from the Wuhu Hospital, affiliated with East China Normal University who were candidates for clopidogrel therapy. Genes influencing clopidogrel's absorption and metabolism were analyzed to guide treatment. Patient data were collected, and genotype and metabolic type distributions were compared. Patients needing medication adjustments were followed up and divided into two groups based on whether they received adjustments or not, and the re-admission rates for antiplatelet therapy within 12 months were compared.

Results: The 430 samples showed the expected genotypes and gene distribution, with no significant correlation to age or sex. The CYP2C19 metabolic phenotype frequency was moderate at 57.44%, fast at 25.12%, slow at 15.58%, and ultra-fast at 1.86%. The ABCB1-3435C>T genotype distribution was wild type in 38.14%, heterozygous in 42.33%, and mutant homozygous in 19.53%, with the TT group being significantly younger. The PON1-576G>A genotype showed no significant baseline differences. Of the 279 patients needing medication advice, 39.07% received it. The adjusted group had a significantly lower re-admission rate within one year.

Conclusion: The distribution of gene polymorphisms related to clopidogrel metabolism varied within the study population, indicating a potential for personalized medication approaches. The study provides insight into the clinical application of genetic testing for clopidogrel therapy.