Genetic polymorphisms of the platelet receptors P2Y 12 , P2Y 1 and GP IIIa and response to aspirin and clopidogrel

Eli I. Lev, Rajnikant T. Patel, Sasidhar Guthikonda, David Lopez, Paul F. Bray, Neal S. Kleiman

Research output: Contribution to journalArticle

130 Citations (Scopus)

Abstract

Introduction: There is wide variability in the responses of individual patients to aspirin and clopidogrel. Polymorphisms of several platelet receptors have been related to increased platelet aggregation. We therefore aimed to evaluate whether these polymorphisms are related to altered response to aspirin or clopidogrel. Materials and methods: Patients (n = 120) undergoing percutaneous coronary intervention who received aspirin for ≥ 1 week but not clopidogrel were included. Blood samples were drawn at baseline and 20-24 h after a 300-mg clopidogrel dose. Aspirin insensitivity was defined as 5 μM ADP-induced aggregation ≥ 70% and 0.5 mg/mL arachidonic acid-induced aggregation ≥ 20%. Clopidogrel insensitivity was defined as baseline minus post-treatment aggregation ≤ 10% in response to 5 and 20 μM ADP. PlA polymorphism of glycoprotein IIIa, T744C polymorphism of the P2Y 12 gene and the 1622A > G polymorphism of the P2Y 1 gene were genotyped by polymerase chain reaction. Results: There were no differences in polymorphism frequencies between drug-insensitive vs. drug-sensitive patients. There were also no significant differences in response to aspirin (assessed by arachidonic acid-induced aggregation) or to clopidogrel (assessed by ADP-induced aggregation or activation markers) when patients were grouped according to genotype. The only trend observed was lower reduction in PAC-1 binding following clopidogrel in PlA 2 carriers (P = 0.065). Conclusions: We did not find an association between polymorphisms in the platelet receptors GP IIIa, P2Y 12 or P2Y 1 and response to aspirin or clopidogrel in cardiac patients. These findings suggest that the variability in response to anti-platelet drugs is multi-factorial and is not caused only by single gene mutations.

Original languageEnglish (US)
Pages (from-to)355-360
Number of pages6
JournalThrombosis Research
Volume119
Issue number3
DOIs
StatePublished - Jan 1 2007
Externally publishedYes

Fingerprint

clopidogrel
Genetic Polymorphisms
Aspirin
Blood Platelets
Adenosine Diphosphate
Arachidonic Acid
Pharmaceutical Preparations
Genes
Percutaneous Coronary Intervention
Platelet Aggregation

Keywords

  • Aspirin
  • Clopidogrel
  • Platelets
  • Polymorphism

ASJC Scopus subject areas

  • Hematology

Cite this

Genetic polymorphisms of the platelet receptors P2Y 12 , P2Y 1 and GP IIIa and response to aspirin and clopidogrel . / Lev, Eli I.; Patel, Rajnikant T.; Guthikonda, Sasidhar; Lopez, David; Bray, Paul F.; Kleiman, Neal S.

In: Thrombosis Research, Vol. 119, No. 3, 01.01.2007, p. 355-360.

Research output: Contribution to journalArticle

Lev, Eli I. ; Patel, Rajnikant T. ; Guthikonda, Sasidhar ; Lopez, David ; Bray, Paul F. ; Kleiman, Neal S. / Genetic polymorphisms of the platelet receptors P2Y 12 , P2Y 1 and GP IIIa and response to aspirin and clopidogrel In: Thrombosis Research. 2007 ; Vol. 119, No. 3. pp. 355-360.
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abstract = "Introduction: There is wide variability in the responses of individual patients to aspirin and clopidogrel. Polymorphisms of several platelet receptors have been related to increased platelet aggregation. We therefore aimed to evaluate whether these polymorphisms are related to altered response to aspirin or clopidogrel. Materials and methods: Patients (n = 120) undergoing percutaneous coronary intervention who received aspirin for ≥ 1 week but not clopidogrel were included. Blood samples were drawn at baseline and 20-24 h after a 300-mg clopidogrel dose. Aspirin insensitivity was defined as 5 μM ADP-induced aggregation ≥ 70{\%} and 0.5 mg/mL arachidonic acid-induced aggregation ≥ 20{\%}. Clopidogrel insensitivity was defined as baseline minus post-treatment aggregation ≤ 10{\%} in response to 5 and 20 μM ADP. PlA polymorphism of glycoprotein IIIa, T744C polymorphism of the P2Y 12 gene and the 1622A > G polymorphism of the P2Y 1 gene were genotyped by polymerase chain reaction. Results: There were no differences in polymorphism frequencies between drug-insensitive vs. drug-sensitive patients. There were also no significant differences in response to aspirin (assessed by arachidonic acid-induced aggregation) or to clopidogrel (assessed by ADP-induced aggregation or activation markers) when patients were grouped according to genotype. The only trend observed was lower reduction in PAC-1 binding following clopidogrel in PlA 2 carriers (P = 0.065). Conclusions: We did not find an association between polymorphisms in the platelet receptors GP IIIa, P2Y 12 or P2Y 1 and response to aspirin or clopidogrel in cardiac patients. These findings suggest that the variability in response to anti-platelet drugs is multi-factorial and is not caused only by single gene mutations.",
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N2 - Introduction: There is wide variability in the responses of individual patients to aspirin and clopidogrel. Polymorphisms of several platelet receptors have been related to increased platelet aggregation. We therefore aimed to evaluate whether these polymorphisms are related to altered response to aspirin or clopidogrel. Materials and methods: Patients (n = 120) undergoing percutaneous coronary intervention who received aspirin for ≥ 1 week but not clopidogrel were included. Blood samples were drawn at baseline and 20-24 h after a 300-mg clopidogrel dose. Aspirin insensitivity was defined as 5 μM ADP-induced aggregation ≥ 70% and 0.5 mg/mL arachidonic acid-induced aggregation ≥ 20%. Clopidogrel insensitivity was defined as baseline minus post-treatment aggregation ≤ 10% in response to 5 and 20 μM ADP. PlA polymorphism of glycoprotein IIIa, T744C polymorphism of the P2Y 12 gene and the 1622A > G polymorphism of the P2Y 1 gene were genotyped by polymerase chain reaction. Results: There were no differences in polymorphism frequencies between drug-insensitive vs. drug-sensitive patients. There were also no significant differences in response to aspirin (assessed by arachidonic acid-induced aggregation) or to clopidogrel (assessed by ADP-induced aggregation or activation markers) when patients were grouped according to genotype. The only trend observed was lower reduction in PAC-1 binding following clopidogrel in PlA 2 carriers (P = 0.065). Conclusions: We did not find an association between polymorphisms in the platelet receptors GP IIIa, P2Y 12 or P2Y 1 and response to aspirin or clopidogrel in cardiac patients. These findings suggest that the variability in response to anti-platelet drugs is multi-factorial and is not caused only by single gene mutations.

AB - Introduction: There is wide variability in the responses of individual patients to aspirin and clopidogrel. Polymorphisms of several platelet receptors have been related to increased platelet aggregation. We therefore aimed to evaluate whether these polymorphisms are related to altered response to aspirin or clopidogrel. Materials and methods: Patients (n = 120) undergoing percutaneous coronary intervention who received aspirin for ≥ 1 week but not clopidogrel were included. Blood samples were drawn at baseline and 20-24 h after a 300-mg clopidogrel dose. Aspirin insensitivity was defined as 5 μM ADP-induced aggregation ≥ 70% and 0.5 mg/mL arachidonic acid-induced aggregation ≥ 20%. Clopidogrel insensitivity was defined as baseline minus post-treatment aggregation ≤ 10% in response to 5 and 20 μM ADP. PlA polymorphism of glycoprotein IIIa, T744C polymorphism of the P2Y 12 gene and the 1622A > G polymorphism of the P2Y 1 gene were genotyped by polymerase chain reaction. Results: There were no differences in polymorphism frequencies between drug-insensitive vs. drug-sensitive patients. There were also no significant differences in response to aspirin (assessed by arachidonic acid-induced aggregation) or to clopidogrel (assessed by ADP-induced aggregation or activation markers) when patients were grouped according to genotype. The only trend observed was lower reduction in PAC-1 binding following clopidogrel in PlA 2 carriers (P = 0.065). Conclusions: We did not find an association between polymorphisms in the platelet receptors GP IIIa, P2Y 12 or P2Y 1 and response to aspirin or clopidogrel in cardiac patients. These findings suggest that the variability in response to anti-platelet drugs is multi-factorial and is not caused only by single gene mutations.

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