BackgroundThe genetic profile may contribute to interindividual differences in clopidogrel response among patients with acute coronary syndrome (ACS). Although CYP2C19 variants have documented established recommendations that they have contributed to reducing the efficacy of medication, the clinical impact of ABCB1 polymorphisms on clopidogrel bioavailability and subsequent clinical outcome remains controversial. This study evaluates the role of ABCB1 and CYP2C19 variants with major adverse cardiovascular events (MACE) in patients with ACS in a sample obtained from the United Arab Emirates (UAE).MethodsThis retrospective cohort study included 174 patients with ACS treated with clopidogrel. Genotyping for ABCB1 and CYP2C19 variants was performed using real-time PCR® TaqMan assays. Associations with 1-year MACE outcome were assessed using genotype, carrier status, and dominant and recessive models. A multivariable logistic regression analysis was also conducted.ResultsThe minor allele frequencies for the ABCB1 gene variants, rs1045642, rs2032582, and rs1128503, were 48.85%, 50%, and 51.44%, respectively. The presence of ABCB1 alleles had no significant correlation outcomes with MACE, regardless of the genetic models used (p-value > 0.05). CYP2C19*2 was associated with a weak trend of increased risk of MACE in the dominant model (RR = 1.41; 95% CI: 0.95–2.10; p-value = 0.08), whereas the rare CYP2C19*3 (1.15%) was not significantly related to any of the outcomes. In multivariable logistic regression, only age showed a non-significant trend toward higher risk.ConclusionThe study did not find any significant link between common ABCB1 variants and MACE in patients with ACS treated with clopidogrel from the UAE sample. None of these variants were found to be predictors of outcomes after a multivariate analysis was performed. These findings suggest limited current utility for ABCB1 variants in clopidogrel response.
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