3480 Association of Clopidogrel Resistance Determinants and MACE Ocurrence in Peripheral Arterial Disease

Abstract

OBJECTIVES/SPECIFIC AIMS: The study aims to identify the short and long-term associations of HTPR and presence of CYP2C19 polymorphism in the occurrence of major adverse cardiovascular events (MACE). The primary outcome of the study will be the presence of MACE including stent thrombosis, need for revascularization, acute limb ischemia events, myocardial infarction and death in relation to the presence of HTPR and CYP2C19 polymorphism. Secondary outcomes will include the prevalence of HTPR and CYP2C19 polymorphism in patients with PAD, and association with other medications including aspirin and cilostazol. METHODS/STUDY POPULATION: Patients above 21 years of age with the diagnosis of PAD using clopidogrel therapy for at least for seven days will be recruited at the University of Puerto Rico District Hospital and Cardiovascular Hospital of Puerto Rico and the Caribbean. RESULTS/ANTICIPATED RESULTS: A total of 200 patients from Puertorrican, Dominican and Cuban ethnicity will be expected to be recruited. The most common comorbidities will include, coronary artery disease, hypertension, dyslipidemia, and diabetes mellitus type 2. No significant distr DISCUSSION/SIGNIFICANCE OF IMPACT: The status quo as it pertains to resistance to clopidogrel in PAD patients is to improve antiplatelet resistance using antiplatelet therapy guided by platelet assays in order to reduce MACE occurrence. Although HTPR and presence of CYP2C19 polymorphisms have been studied on the PAD population, currently there is no gold standard test for measuring antiplatelet resistance. In that regard, this study will expect to identify the contribution that HTPR and CYP2C19 polymorphism might have on MACE in patients with PAD. In this way, the results will allow identification of abnormality parameters in HTPR and CYP2C19 testing in relation to the impact on risk of having MACE. Once the association of these variables with MACE is established, testing for clopidogrel resistance could become a potential strategy to optimize antiplatelet therapy and reduce the impact that MACE have in this population.