Both Martínez-Quintana and Medina-Gil contributed equally to this work.
Special Section: Clopidogrel
Positive clinical response to clopidogrel is independent of paraoxonase 1 Q192R and CYP2C19 genetic variants
Article first published online: 14 FEB 2014
© 2014, The American College of Clinical Pharmacology
The Journal of Clinical Pharmacology
Volume 54, Issue 8, pages 843–849, August 2014
How to Cite
Martínez-Quintana, E., Medina-Gil, J. M., Rodríguez-González, F., Garay-Sánchez, P., Limiñana, J. M., Saavedra, P. and Tugores, A. (2014), Positive clinical response to clopidogrel is independent of paraoxonase 1 Q192R and CYP2C19 genetic variants. Journal of Clinical Pharma, 54: 843–849. doi: 10.1002/jcph.275
- Issue published online: 5 JUL 2014
- Article first published online: 14 FEB 2014
- Accepted manuscript online: 6 FEB 2014 09:51AM EST
- Manuscript Accepted: 3 FEB 2014
- Manuscript Received: 16 OCT 2013
- FUNCIS. Grant Number: 16/06
- FUNCIS BIOREGION
- Servicio Canario de Salud
- Instituto de Salud Carlos III. Grant Numbers: IF 05/3705, IF 06/3632, IF 07/3616, IF 08/3620
There is increasing controversy about the influence of serum paraoxonase type 1 and cytochrome CYP2C19 in the conversion of clopidogrel to its pharmaceutically active metabolite. The effect of concomitant medication with the proton pump inhibitor omeprazole has been also subject of intense scrutiny.
We present a cohort of 263 patients receiving anti-platelet aggregation treatment with clopidogrel and aspirin for 1 year. The paraoxonase 1 gene Q192R variant along with the presence of CYP2C19*2 and *3 loss of function alleles, concomitant medication with proton pump inhibitors and known cardiovascular risk factors were examined to determine their influence in disease relapse due to an ischaemic event during the 12 month treatment period.
The low number of patients suffering a relapse (20 out of 263), indicates that double anti-aggregation therapy with aspirin and clopidogrel was very effective in our patients. Among the relapsers, evidence of coronary heart disease was the most influencial factor affecting response to therapy, while the presence of the paraoxonase 1 Q192R variant, loss of function of CYP2C19, and concomitant medication with omeprazole were non-significant.