Adrenergic receptor polymorphisms and platelet reactivity after treatment with dual antiplatelet therapy with aspirin and clopidogrel in acute coronary syndrome
- PMID: 20135061
- DOI: 10.1160/TH09-06-0355
Adrenergic receptor polymorphisms and platelet reactivity after treatment with dual antiplatelet therapy with aspirin and clopidogrel in acute coronary syndrome
Abstract
Platelet response to clopidogrel shows inter-individual variability that is partially explained by genetic polymorphisms. This variability affects clinical outcome when clopidogrel is administered in patients with acute coronary syndrome (ACS). Catecholamines, released during ACS, contribute to platelet aggregation through platelet alpha2A-(alpha2A-AR) and beta2-adrenergic receptor (beta2-AR) stimulation. It was the objective of this study to assess the potential influence of alpha2A-AR and beta2-AR gene polymorphisms on platelet reactivity after dual antiplatelet therapy with aspirin and clopidogrel in ACS. We screened 641 ACS patients for 6.3/6.7 kb alpha2A-AR polymorphism, and for Arg16Gly and Gln27Glu beta2-AR polymorphism. After 600 mg clopidogrel, we assessed ADP 10 micromol-induced platelet aggregation (ADP-Ag) and vasoactive stimulated phosphoprotein (VASP). All single nucleotide polymorphisms were in Hardy-Weinberg equilibrium. A slight though negligible association was found between 6.3 kb allele of alpha2A-AR with platelet reactivity ADP-Ag induced (beta: -2.91 [-5.68;-0.14], p=0.04). A borderline not significant reduction in PRI VASP was observed in 6.3 kb alpha2A-AR carriers (beta: -3.81 [-0.09;7.72], p=0.06). No significant effect on platelet parameters was observed for the other tested polymorphisms. Common alpha2A- and beta2-adrenergic receptor polymorphisms do not show any major impact on residual platelet reactivity in non-ST-elevation ACS when a dual antiplatelet therapy with 250 mg aspirin and 600 mg clopidogrel is administered.
Similar articles
-
Lack of association between the 807 C/T polymorphism of glycoprotein Ia gene and post-treatment platelet reactivity after aspirin and clopidogrel in patients with acute coronary syndrome.Thromb Haemost. 2007 Feb;97(2):212-7. Thromb Haemost. 2007. PMID: 17264949 Clinical Trial.
-
Role of the T744C polymorphism of the P2Y12 gene on platelet response to a 600-mg loading dose of clopidogrel in 597 patients with non-ST-segment elevation acute coronary syndrome.Thromb Res. 2007;120(6):893-9. doi: 10.1016/j.thromres.2007.01.012. Epub 2007 Mar 6. Thromb Res. 2007. PMID: 17337040
-
Effect of cytochrome p450 polymorphisms on platelet reactivity after treatment with clopidogrel in acute coronary syndrome.Am J Cardiol. 2008 Apr 15;101(8):1088-93. doi: 10.1016/j.amjcard.2007.11.065. Epub 2008 Feb 6. Am J Cardiol. 2008. PMID: 18394438
-
Indications for dual antiplatelet therapy with aspirin and clopidogrel: evidence-based recommendations for use.Ann Pharmacother. 2008 Apr;42(4):550-7. doi: 10.1345/aph.1K433. Epub 2008 Mar 4. Ann Pharmacother. 2008. PMID: 18319394 Review.
-
The future of platelet function testing to guide therapy in clopidogrel low and enhanced responders.Expert Rev Cardiovasc Ther. 2011 Aug;9(8):999-1014. doi: 10.1586/erc.11.80. Expert Rev Cardiovasc Ther. 2011. PMID: 21878045 Review.
Cited by
-
Genetically Determined Platelet Reactivity and Related Clinical Implications.High Blood Press Cardiovasc Prev. 2015 Sep;22(3):257-64. doi: 10.1007/s40292-015-0104-5. Epub 2015 May 19. High Blood Press Cardiovasc Prev. 2015. PMID: 25986078 Review.
-
Beyond the heart: a review exploring non-cardiovascular effects of vasoactive agents.Front Pharmacol. 2025 Jul 10;16:1533437. doi: 10.3389/fphar.2025.1533437. eCollection 2025. Front Pharmacol. 2025. PMID: 40709092 Free PMC article. Review.
-
Role of platelet α2-adrenoreceptor in biological low response to Clopidogrel for patients with non cardioembolic ischemic stroke or transient ischemic attack.Am J Transl Res. 2018 Aug 15;10(8):2712-2721. eCollection 2018. Am J Transl Res. 2018. PMID: 30210708 Free PMC article.
-
Clinical impact of genetically determined platelet reactivity.J Cardiovasc Transl Res. 2013 Jun;6(3):398-403. doi: 10.1007/s12265-012-9421-4. Epub 2012 Nov 13. J Cardiovasc Transl Res. 2013. PMID: 23149816 Review.
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials