The link between the AKR1D1*36 (rs1872930) allele and risk of major adverse cardiovascular and cerebrovascular events (MACCE) in patients taking clopidogrel has been examined in a recent observational pharmacogenomic cohort study. 118 patients (median age 62.5 years) with cardiovascular or cerebrovascular symptoms admitted between October – November 2010 were included in the study, with a median follow up time of 38.5 months. Data analysis showed a significantly shorter event-free survival associated with patients carrying the AKR1D1*36 allelic variant when compared to wild type patients (hazard ratio = 2.193; 95% CI = 1.091 – 4.406; p = 0.0155). In addition, the AKR1D1*36 allele was identified as an independent risk factor (HR = 2.36; 95% CI = 1.34 – 4.18). Three additional risk factors contributing to MACCE events were confirmed: previous percutaneous interventions (HR = 2.78; 95% CI = 1.34 – 5.78), previous myocardial infarction (HR = 2.62; 95% CI = 1.48 – 4.64) at baseline and previously reported CYP2C19*2 polymorphism (HR = 2.33; 95% CI = 1.33 – 4.06). The study, which can be viewed here, confirms the association between the AKR1D1*36 (rs1872930) variant, increased MACCE risk and shorter event-free survival amongst people taking clopidogrel.
Contributed by Australian Medication Safety Services Associate – Isabella Singh