CES1 gene polymorphism effect on the antiplatelet activity of clopidogrel

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To investigate the association of the rs2244613 polymorphism in the CES1 gene with resistance to clopidogrel after percutaneous coronary intervention in patients with acute coronary syndrome (ACS).

Material and methods

We studied 81 patients with ACS and 136 healthy volunteers. All patients with ACS were treated with aspirin and clopidogrel. Platelets residual reactivity was measured within 2 to 5 days after developemnt of ACS by optical detection of platelet agglutination (VerifyNow). The rs2244613 polymorphism was determined by real-time polimerase chain reaction.


The genotypes AA, AC and CC for rs224613 of CES1 gene were found in 37 (45.6%), 42 (51.8%), and 2 (2.6%) patients with ACS and in 70 (51.5%), 55 (40.4%) and 11 (8.1%) healthy volunteers, respectively. In rs2244613 carriers, the platelets residual reactivity was significantly higher than in patients who did not have rs2244613 : 183.23 ± 37.24 v s 154.3 ± 60.36 PRU (p = 0.01). The minor allele occurred in 2 8.4% of patients ACS and in 28.3% of healthy participants. T here was no statistically significant difference in the prevalence of rs2244613 between healthy volunteers and patients with ACS (p>0.05).


We found a statistically significant association between the carriage rs2244613 polymorphism in the CES1 gene and the platelet residual aggregation in patients with ACS who were treated with clopidogrel after the percutaneous coronary intervention. The occurence of rs2244613 polymorphism was similar in patients with ACS and healthy volunteers.

Key words

Clopidogrel, ACS, CES1, rs2244613, antiplatelet therapy