Common heart disease blood-thinner ineffective for numerous south Asian patients: Study

This research highlights a concerning trend, particularly for individuals of Bangladeshi and Pakistani ancestry

• Kimberly Rodrigues
• 28 August, 2023

By: Kimberly Rodrigues

A commonly prescribed blood-thinner, clopidogrel (Plavix), may not be effective for individuals of South Asian descent due to a genetic mutation, a study suggests.

The research reveals that over half of those with Bangladeshi and Pakistani heritage have a genetic mutation that hinders the proper function of clopidogrel, the Daily Mail reported.

Clopidogrel is widely used to reduce the risk of heart attacks and strokes by preventing blood cells from forming dangerous clots.

It has been observed that many individuals do not respond to this medication, attributed to a genetic mutation in the CYP2C19 gene, which is responsible for producing an enzyme needed to activate the drug.

Prior studies involving European populations estimated this phenomenon in approximately a third of cases.

Conducted by researchers from Queen Mary University of London, a new study examined the DNA of over 40,000 British south Asians, revealing a much higher prevalence of the genetic mutation in this population.

Among those studied, 57 percent carried the genetic alteration that renders clopidogrel ineffective. Worryingly, two-thirds of participants had been prescribed clopidogrel to prevent secondary heart attacks or strokes.

This research highlights a concerning trend, particularly for individuals of Bangladeshi and Pakistani ancestry, who face a more than threefold risk of recurrent heart attacks compared to those of European heritage.

The study implies that treatment failure with clopidogrel could contribute to this elevated risk.

Lead author Dr Emma Magavern, supported by the National Institute for Health and Care Research and Barts Charity, emphasised the significance of incorporating genetic factors to determine the suitability of clopidogrel after a heart attack.

Neglecting this consideration could disproportionately disadvantage specific population groups.

Dr Magavern further underscored the importance of inclusive medical trials, emphasizing that underrepresentation of south Asians in research has obscured our comprehension of risks within this community.

Various alternatives to clopidogrel are available, including warfarin, aspirin, and newer blood thinners like dabigatran.