BMC Neurology (Jun 2024)

The association between abcb1 gene polymorphism and clopidogrel response variability in stroke ischemic: a cross sectional study

  • Rakhmad Hidayat,
  • Rizqi Amanda Nabilah,
  • Marc Fisher,
  • Tiara Aninditha,
  • Mohammad Kurniawan,
  • Riwanti Estiasari,
  • Luh Ari Indrawati,
  • Ahmad Yanuar Safri,
  • Taufik Mesiano,
  • Al Rasyid,
  • Salim Harris

DOI
https://doi.org/10.1186/s12883-024-03723-y
Journal volume & issue
Vol. 24, no. 1
pp. 1 – 9

Abstract

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Abstract Background Clopidogrel has been the primary choice of antiplatelet in ischemic stroke that inhibits adenosine diphosphate (ADP)-induced platelet aggregation. P-glycoprotein (P-gp) multidrug resistance-1 (MDR1) is a transmembrane efflux transporter in intestinal cells that plays a significant role in clopidogrel absorption, therefore may affect platelet aggregation. P-gp is encoded by the ABCB1 gene. This study aims to evaluate the effect of ABCB1 polymorphism on clopidogrel response variability in ischemic stroke patients and its genotype frequency. Methods A cross-sectional study was conducted in ischemic stroke patients who received clopidogrel between 2020 and 2023 in RSUI/RSCM. All subjects were assessed for ABCB1 polymorphisms C3435T and C1236T. Platelet aggregation were measured using VerifyNow PRU. Clopidogrel response variability was classified into unresponsive (> 208 PRU), responsive (95–208 PRU), and bleeding risk (< 95 PRU). Results 124 subjects enrolled in this study, with 12,9% of subjects classified as non-responsive/resistant, 49,5% as responsive, and 41,9% as bleeding risk. ABCB1 C1236T homozygote wildtype (CC) was associated with 3,76 times higher bleeding risk than other variants (p = 0,008; 95%CI 1,41 − 10,07). Genotype frequency of ABCB1 C3435T homozygote wildtype, heterozygote, and homozygote variants were 35,9%, 43,5% and 16,9%, respectively; while the genotype frequency of ABCB1 C1236T were 17,8%, 39,5%, and 42,7%, respectively. Conclusion ABCB1 C1236T homozygote wildtype was associated with 3,76 times higher bleeding risk than other variants. The most common genotype frequency of ABCB1 C1236T was homozygote variant; while for ABCB1 C3435T was heterozygote.

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