5PSQ-008 CYP2C19 SNP’s influence on clopidogrel response in peripheral artery disease patients

BackgroundClopidogrel is a prodrug, metabolised to its active metabolite especially by the CYP2C19 enzyme. The effect of CYP2C19 polymorphisms on clopidogrel efficacy in coronary disease had been widely researched. The clopidogrel label recommends testing the CYP2C19 loss of function alleles before the start of the treatment and the DPWG and CPIC pharmacogenetic dosing guidelines recommend switching clopidogrel in case of carrying the CYP2C19*2 SNP in coronary patients with stent. This remains unstudied in peripheral artery disease (PAD) patients.PurposeExplore the influence of CYP2C19 genetic polymorphisms on clopidogrel response in PAD patients.Material and methodsPeripheral artery disease patients treated with clopidogrel after percutaneous transluminal angioplasty were recruited. They were tested for carrying the CYP2C19*2, *3 (loss of function (LOF)) and *17 (gain of function (GOF)) allele. The primary endpoint was the occurrence of atherothrombotic ischaemic events, diagnosed by ultrasound imaging, during 12 months’ follow-up. Furthermore, we collected data about clinical parameters (age, sex, ethnicity), co-medication during follow-up, vascular risk factors and surgical parameters.We tested the association between carrying LOF or GOF alleles and the primary endpoint in a univariate analysis, and multivariate analysis including those clinical parameters previously related to clopidogrel response. OR and HR were calculated and P-values