The following is a summary of “Association between abcb1 gene polymorphism and clopidogrel response variability in stroke ischemic: a cross sectional study,” published in the June 2024 issue of Neurology by Hidayat, et al.
Clopidogrel, an antiplatelet medication for ischemic stroke that inhibits adenosine diphosphate (ADP)-induced platelet aggregation, is affected by P-glycoprotein (P-glycoprotein (P-gp) multidrug resistance-1 (MDR1)), a transporter protein in the intestine that influences its absorption.
Researchers conducted a retrospective study investigating how variations in the ABCB1 gene (which codes for P-gp) affect clopidogrel response and the prevalence of these variations in patients with ischemic stroke.
They involved patients with ischemic stroke treated with clopidogrel(2020 to 2023) at RSUI/RSCM. All participants were evaluated for ABCB1 gene variations C3435T and C1236T. Platelet aggregation was assessed using VerifyNow PRU. The variability in clopidogrel response was categorized into unresponsive (>208 PRU), responsive (95–208 PRU), and bleeding risk (<95 PRU).
The results showed 124 subjects, with 12.9% classified as non-responsive (>208 PRU), 49.5% as responsive (95-208 PRU), and 41.9% as bleeding risk (<95 PRU). The ABCB1 C1236T homozygote wildtype (CC) showed a 3.76-fold higher bleeding risk than other variants (P=0.008; 95% CI 1.41-10.07). The genotype frequencies for ABCB1 C3435T were 35.9% (homozygote wildtype), 43.5% (heterozygote), and 16.9% (homozygote variants), while for ABCB1 C1236T, were 17.8%, 39.5%, and 42.7%, respectively.
Investigators found that the ABCB1 C1236T homozygous wildtype genotype is associated with higher bleeding risk, while the most common genotypes are ABCB1 C3435T heterozygote and ABCB1 C1236T variant.
Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-024-03723-y
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