EVALUATION OF GENE POLYMORPHISMS FOR PERSONALIZING ANTIPLATELET AND ANTICOAGULANT THERAPY

Introduction: Pharmacogenomics uses genetic information to guide the choice of drug and its dose for individualized treatment. Antiplatelets are a group of medicines that prevent platelets from aggregating to form a blood clot. Antiplatelet therapy is prescribed for various diseases which include CAD, MI, angina, stroke, transient ischemia, PVD. The most common antiplatelet & anticoagulant drugs used are Clopidogrel and Warfarin. These drugs which are metabolized by the enzymes CYP2C19 and VKORC1 respectively have several polymorphisms. In the present study functional variants of these genes were identied to plan appropriate therapy. Methods: In this retrospective study, 108 individuals (95 adults and 13 pediatric cases) were evaluated for the CYP2C19 and VKORC1 gene polymorphisms by PCR of the genomic DNA isolated from EDTA blood sample. The PCR products were analyzed by sequencing. Results: In our population, 5 variant alleles of CYP2C19 -*2, *6, *8, *17, *19 were identied, while *1 was the reference allele. Only 12.03% of the sample had homozygous *1/*1 requiring standard dose, while the others were either intermediate (47.23%), poor (15.74%) or rapid (20.37%) metabolizers. The variant allele of VKORC1 was *2 while *1 was the reference allele, based on this 51.85% of the cases were Warfarin sensitive and 48.15% were resistant. Conclusion: CYP2C19 and VKORC1 genotyping should be used to guide personalized antiplatelet & anticoagulant (clopidogrel/warfarin) therapy for personalized therapy and best outcomes/response.