A research investigation has disclosed that 57% of individuals of South Asian descent in the United Kingdom possess a genetic mutation that inhibits the efficacy of the antiplatelet drug clopidogrel, thereby elevating the probability of experiencing additional heart attacks. The study accentuates the necessity for prescriptions based on genetic profiling, particularly among demographics prone to elevated cardiovascular risk.
Clopidogrel is frequently administered as a preventive measure against successive cardiac events following an initial heart attack. To function optimally, the drug needs to be bioactivated within the human body. Existing studies on populations of European descent have shown that approximately 30% possess genetic mutations that either decrease or completely obstruct this activation, primarily through the formation of an enzyme named CYP2C19.
Previous research has highlighted the prevalence of cardiovascular disorders among individuals with South Asian heritage, yet no studies had specifically examined the presence of these genetic variants in the South Asian population in the UK, or connected these variants to an augmented risk of subsequent cardiac events when prescribed clopidogrel.
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Research Focused on the South Asian Demographic in the UK
The investigators scrutinized the health records of 44,396 British individuals of Bangladeshi and Pakistani origin, who were part of the Genes & Health cohort and had consented to the linkage of their genetic information with their extended health history. The study revealed that 57% of the subjects possess the genetic alteration that renders them incapable of metabolizing clopidogrel. Among British South Asians in the Genes & Health cohort who had previously suffered a heart attack, over two-thirds had been prescribed the medication.
Potential for Increased Incidence of Subsequent Heart Attacks
Upon analyzing long-term health data, the researchers found that individuals with two loss-of-function CYP2C19 variants were over thrice as likely to experience recurrent heart attacks, potentially due to the ineffectiveness of clopidogrel treatment.
Dr. Emma Magavern, the principal author and a clinical physician and researcher at Queen Mary University of London, stated: “Clopidogrel has primarily demonstrated efficacy in preventing heart attacks in people of European descent. Our study is the first to reveal that genetic mutations rendering clopidogrel ineffective occur at significantly higher rates (57%) in British individuals of Bangladeshi and Pakistani heritage, and are associated with an elevated risk of experiencing another heart attack when treated with this drug.”
The study underlines the significance of employing genetic information to ascertain who may benefit from clopidogrel post-heart attack and highlights the likely unequal impact on specific demographics like South Asians if this is not done.
The study also emphasizes the systemic neglect of South Asians in pharmaceutical trials, which has resulted in an obscured understanding of the overlapping risks affecting this community.
Fiona Miller Smith, the Chief Executive of Barts Charity, a funder of the research, commented: “Barts Charity is dedicated to financing health research that contributes to improved healthcare for everyone in our diverse East London community. Given the high incidence of cardiovascular diseases in the East London South Asian population, we are encouraged by the results of this pivotal study, which promises to advance treatment protocols for this demographic.”
The study received financial support from Barts Charity and the NIHR Biomedical Research Centre and was published in JACC: Advances with the DOI reference 10.1016/j.jacadv.2023.100573.
Frequently Asked Questions (FAQs) about Clopidogrel Ineffectiveness in British South Asians
What is the significance of this research on clopidogrel effectiveness in British South Asians?
This research is significant because it reveals that 57% of British South Asians have a genetic variant that prevents the antiplatelet drug clopidogrel from being effective. This genetic variation increases the risk of recurrent heart attacks among this demographic.
What is clopidogrel, and why is it prescribed?
Clopidogrel is a commonly prescribed medication used to prevent subsequent heart attacks after the first occurrence. It works by preventing blood clots that can lead to heart attacks.
How does clopidogrel work, and why does genetics matter?
Clopidogrel needs to be activated within the body to be effective. Genetic variants, specifically CYP2C19 mutations, can affect this activation process. This research highlights that certain genetic variants are more common among British South Asians, making clopidogrel less effective for them.
What were the key findings of the study?
The study found that British South Asians with these genetic mutations were over three times more likely to experience recurrent heart attacks when prescribed clopidogrel. This emphasizes the importance of genetic profiling for drug prescriptions.
Why is genetic profiling important in healthcare?
Genetic profiling helps determine how individuals metabolize drugs, allowing for personalized treatment plans. This can improve drug efficacy and reduce the risk of adverse reactions.
How does this research impact healthcare for British South Asians?
The research highlights the need for genetic-based prescriptions, especially among high-risk groups like British South Asians, to ensure that medications like clopidogrel are effective in preventing heart attacks in these populations.
What does this study reveal about underrepresentation in pharmaceutical trials?
The study sheds light on the systemic underrepresentation of South Asians in pharmaceutical trials, which has limited our understanding of how drugs work in diverse populations and the associated risks.
Who funded this research, and where was it published?
This research received funding from Barts Charity and the NIHR Biomedical Research Centre. It was published in JACC: Advances with the DOI reference 10.1016/j.jacadv.2023.100573.
More about Clopidogrel Ineffectiveness in British South Asians
- JACC: Advances Article
- NIHR Biomedical Research Centre
- Barts Charity
- Genes & Health Cohort
- CYP2C19 Genetic Variant
2 comments
wow, this study is like so important! genetics matter, y’know? they found 57% of south asians cant use clop drogel, scary stuff
Clopidogrel, common drug for heart attacks, not work for many British South Asians. Need genetic tests for meds!