Cytochrome P-450 CYP2C19
In biology, the cytochrome P-450 CYP2D19 is an isoenzyme of cytochrome P-450. 2-6% of anglos and 15-25% of asians are poor metabolizers of drugs that use the CYP2C19 isoenzyme. More recently, a study suggests that 30% of patients may have a reduced-function allele with the reduced function allele being more common in asians and africans and less common in anglos and hispanics.
CYP2C19 polymorphism may affect response to clopidogrel. A systematic review of association studies concluded CYP2C19 "genetic association studies does not indicate a substantial or consistent influence of CYP2C19 gene polymorphisms on the clinical efficacy of clopidogrel." Prior studies were conflicting whether loss-of-function alleles are associated with more cardiovascular events. Concomitant proton pump inhibitors, which are also metabolized by CYP2C19, may (especially inhibitors other than pantoprazole) or may not increase adverse cardiac events.
In one negative analysis, adding PPIs to clopidogrel as associated with increased adverse events, but not more so than adding PPIs to patients not taking clopidogrel.
- Entrez Gene: 1557; PubMed: search
- Entrez Nucleotide: NG_008384; PubMed search
- Entrez Protein: 55660867; PubMed search
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