Abstract
CYP2C19 metabolizes clopidrogel, which is now indicated for the prophylaxis of arterial thrombosis in patients with cardiovascular disease, especially after the introduction of the coronary stent.Genetic damage that leads to the small effect of this drug is a substitution G> A at position 681 of exon 5 (allele CYP2C19 * 2) and 2C19 * 3 allele (substitution G> A in position 636 of exon 4). The combination of alleles of CYP2C19 * 1 / * 1 (74% of the population) is responsible for t.zv. rapid metabolism of these drugs, moderately fast metabolism causing the combination of CYP2C19 * 1 / * 2 or CYP2C19 * 1 / * 3 (26% of the population), the slow metabolism of CYP2C19 * 2 / * 2, CYP2C19 * 2 / * 3 or CYP2C19 * 3 / * 3 (2% of the population).
The resulting concentration is then at slow metabolisers the therapeutic effect. There is thrombosis of stents and delivery of acute coronary events and increases their mortality and mortality.