THE FREQUENCY OF CYP2C19 ALLELIC VARIANTS IN PATIENTS WITH ACUTE CORONARY SYNDROME IN CENTRAL, EASTERN, NORTHERN SIBERIA AND MOSCOW REGION
Objective. An important aspect of current cardiology practice is resistance to clopidogrel - P2Y12-receptor blocker prescribed in a part of dual antiplatelet therapy for prevention of thrombosis of the stent in patients after ACS. The purpose of this review is to study in Moscow and the Siberian regions of frequencies “slow” allele CYP2C19 gene associated with resistance to clopidogrel, and “rapid” allele associated with the risk of bleeding. Material and methods. The study included 512 residents of large cities in Central (Novosibirsk, Kemerovo), the East (Irkutsk), North (Surgut), Siberia and Moscow region with acute coronary syndrome undergoing percutaneous coronary intervention. The average age of the patients was 63.9±10.9 years. The proportion of men was 80% (409 people), women - 20% (103 people). All patients received dual antiplatelet therapy has been designated as part of a comprehensive drug therapy. Patients received clopidogrel 300 mg - loading, 75 mg - supports. All patients pharmacogenetic testing was conducted using the polymerase chain reaction in real time to determine the alleles CYP2C19*2, CYP2C19*3 and CYP2C19*17. Results. Among the patients, residents of North, Central, Eastern Siberia and Moscow region carrier frequency of allelic variants of CYP2C19*2 - CYP2C19*3 - CYP2C19*17 was 14.9 - 0.5 - 33.3%, 11.05 - 0.0 - 17.1%, 10.6 - 2.85 - 22.2%, 8 - 0.0 - 15.4%, respectively. In assessing the significance of differences in frequency carrier “slow” and “papid” allelic variants of CYP2C19 gene between patients Russian ethnic group from 4 different regions using the Fisher's exact test, significant differences were obtained only between patients from Central and Eastern by Siberia CYP2C19*3 ( p =0.001, odds ratio (OR): 1.05 (95% confidence interval (CI): 1.01-1.09). Сonclusion. The frequency of the minor allele of CYP2C19*2 ranged from 8.0 to 14.9% in different Russian regions, but the differences were not significant. The frequency of allele CYP2C19*3 ranged from 0.5 to 2.8%, while the frequency of this allele in East and Central Siberia differed significantly, it is likely due to the large number of Buryats living in Eastern Siberia. The frequency of allele CYP2C19*17 ranged from 15.4 to 33.3%.