title: Genetic and Nongenetic Factors Affecting Clopidogrel Response in the Egyptian Population.
abstract: Aspirin and clopidogrel are the mainstay oral antiplatelet regimens, yet a substantial number of major adverse cardiac events (MACE) still occur. Herein, we investigated genetic and nongenetic factors associated with clopidogrel response in Egyptians. In all, 190 Egyptians with acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI), treated with clopidogrel (75 mg/day) for at least a month, were genotyped for CYP2C19 *2, *3, *6, *8, *10, and *17, CES1 G143E and ABCB1*6 and *8. These variants along with nongenetic factors were tested for association with the risk of having MACE in clopidogrel-treated patients. CYP2C19 loss-of-function (LOF) alleles carriers had increased risk of MACE vs. noncarriers (odds ratio 2.52; 95% confidence interval 1.23-5.15, P = 0.011). In a logistic regression, CYP2C19 LOF variants (P = 0.011), age (P = 0.032), and body mass index (BMI, P = 0.039) were significantly associated with the incidence of MACE in patients taking clopidogrel. CYP2C19 genetic variants, age, and BMI are potential predictors associated with variability to clopidogrel response in Egyptians.
authors.affiliation: Department of Biochemistry, Faculty of Pharmacy, Misr International University, Cairo, Egypt.
authors.forename: B M
authors.initials: BM
authors.lastname: Khalil
authors.affiliation: Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Shahin
authors.affiliation: Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, Florida, USA.|Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.
authors.forename: M H M
authors.initials: MH
authors.lastname: Solayman
authors.affiliation: Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
authors.forename: T
authors.initials: T
authors.lastname: Langaee
authors.affiliation: Department of Biochemistry, Faculty of Pharmacy, Misr International University, Cairo, Egypt.|Department of Pharmacy Practice and Clinical Pharmacy, Misr International University, Cairo, Egypt.
authors.forename: M F
authors.initials: MF
authors.lastname: Schaalan
authors.affiliation: Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Gong
authors.affiliation: Department of Biochemistry, Faculty of Pharmacy, Misr International University, Cairo, Egypt.
authors.forename: L N
authors.initials: LN
authors.lastname: Hammad
authors.affiliation: Department of Biochemistry, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.
authors.forename: H O
authors.initials: HO
authors.lastname: Al-Mesallamy
authors.affiliation: Department of Biochemistry, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.
authors.forename: N M
authors.initials: NM
authors.lastname: Hamdy
authors.affiliation: Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: W A
authors.initials: WA
authors.lastname: El-Hammady
authors.affiliation: Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, Florida, USA.|Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, Florida, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Johnson
mesh_terms: D002318:Cardiovascular Diseases / Q000473:pathology; D000077144:Clopidogrel; D003710:Demography; D004534:Egypt; D005006:Ethnicity / Q000235:genetics; D005260:Female; D005787:Gene Frequency / Q000235:genetics; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010597:Pharmacogenetics; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000077144:Clopidogrel; D013988:Ticlopidine