Distribution of CYP2C19 polymorphisms in Mongolian and Han nationals and the choice of specific antiplatelet drugs

Abstract

Background Individualized medication reviews may improve our understanding of the distribution of CYP2C19 polymorphisms in ethnic populations. Objective To evaluate differences in CYP2C19 gene polymorphisms between Mongolian and Han nationals and determine the effect of adjustments of antiplatelet treatments according to the genetic profile in patients undergoing percutaneous coronary intervention (PCI). Setting Prospective, observational, single-center study. Methods 397 patients diagnosed with acute coronary syndrome were enrolled. Additionally, 186 patients undergoing PCI were given different treatments according to their CYP2C19 genotypes. Patients with the genotype of an extensive metabolizers (EMs; *1/*1) were co-administered aspirin 100 mg/day and clopidogrel 75 mg/day, following a loading dose of 300 mg; intermediate metabolizers (IMs; e.g., *1/*2 and *1/*3) and poor metabolizers (PMs; e.g., *2/*2 and *2/*3) were administered a loading dose of 180 mg ticagrelor, followed by a maintenance dose of 90 mg twice a day. Results In Mongolians, 60.79% of patients were EMs, which was significantly higher than that in Han nationals (P = 0.002). In Han individuals, 62.14% of patients were IMs and PMs, which was significantly higher than that in Mongolians (P < 0.05). Three patients died, and the frequency of adverse events during follow-up was significantly higher in patients given conventional treatment than in patients given tailored treatment (P = 0.039). However, differences in metabolism subtypes did not affect the incidence of adverse reactions. Conclusions There were differences in CYP2C19 polymorphisms between Mongolians and Hans. Effective, safe therapy was achieved by tailoring antiplatelet drug therapy based on genotype.

Initial experience with the novel p64MW HPC flow diverter from a cohort study in unruptured anterior circulation aneurysms under dual antiplatelet medication

“…A loss-of-function polymorphism of the CYP2C19, the enzyme responsible for the bioactivation of clopidogrel, has been described in Mongolians. 14 Drugs produced in Mongolia are not always meeting high-quality standards. 15 These circumstances make using flow diverters with reduced thrombogenicity desirable.…”

<p>Inconsistency in race and ethnic classification in pharmacogenetics studies and its potential clinical implications</p>

“…They are intended for the visualization of the complexity of ethnic categorization in pharmacogenetics literature and only reflect how these ethnic categories were classified in the literature we reviewed. A full list of ethnic categories included in this study can be found in Table S2 .

Figure 1Chart of ethnic categories which fall under the NIH term of “Asian”. Note: Data from references 7, 8, 10, 12, 14, 16, 28, 37, 41, 42, 48, 51, 71–73, 87–90.

Figure 2Chart of ethnic categories which fall under the NIH term of “Caucasian”. Note: Data from references 9, 11, 13, 18, 20–26, 28, 34, 37, 42–45, 70, 75, 87, 91–94, 128.

Figure 3Chart of ethnic categories which fall under the NIH term of “Black”. Note: Data from references 11, 15, 16, 19, 26–33, 35–37, 40, 46, 47, 49, 50, 70, 75, 79, 87, 94–97, 129, 130.

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Evaluation of CYP2C19 Genetic Variant and Its Lack of Association with Valproic Acid Plasma Concentrations Among Zhuang and Han Schizophrenia Patients in Guangxi

“…This trajectory of investigation offers a compass for prognosticating patient metabolic phenotypes and furnishing guidance for clinical drug administration. 33 , 34 Within the expanse of the CYP2C19 gene, while an array of SNPs (single nucleotide genetic variants) has surfaced, the preeminent variant sites within the Chinese context involve CYP2C19 *2 and CYP2C19 *3. Within the ambit of our study, we embarked on a comprehensive analysis of the genetic variants manifested at these two allelic loci of the CYP2C19 gene among Zhuang and Han ethnic individuals afflicted with schizophrenia within Guangxi.…”