Credits By: NPR
According to a recent study by researchers at Queen Mary University of London, people of Bangladeshi and Pakistani ancestry receive significantly fewer benefits from a commonly prescribed medication for preventing heart attacks than people of European ancestry.
This study emphasizes the importance of understanding how medical interventions, particularly those in common use, affect various ancestral groups within the population. It was funded by the National Institute for Health and Care Research (NIHR), Barts Biomedical Research Centre, and Barts Charity. To guarantee that everyone has equitable access to effective therapies, this knowledge is crucial.
To be effective, clopidogrel, a frequently prescribed drug used to prevent recurrent heart attacks after a primary incident, must be activated within the body. According to research on populations in Europe, 30% of people have genetic variants that prevent or delay the activation of the CYP2C19 enzyme. Although people of South Asian descent have higher rates of cardiovascular illness, previous research has not looked at these variations in UK South Asian populations or linked them to the likelihood of recurrent heart attacks in these populations when clopidogrel is prescribed.
44,396 British citizens of Bangladeshi and Pakistani descent who were part of the Genes & Health cohort and gave permission for their genetic information to be combined with their long-term health records were the subject of the study’s analysis of health data. According to the study, 57% of participants had a common genetic mutation that prevented them from activating clopidogrel. Clopidogrel had been given to more than two-thirds of the British South Asians in the Genes & Health cohort who had suffered a heart attack.
The research team showed that those with two loss-of-function CYP2C19 variations were nearly three times more likely to have recurrent heart attacks, a condition that may be related to the ineffectiveness of clopidogrel treatment. This finding was supported by the participants’ extended health data.
The principal author, Dr. Emma Magavern, a clinical doctoral candidate and researcher at Queen Mary University of London, said:
“Previous research has mostly demonstrated clopidogrel’s effectiveness in people of European ancestry. This study makes history by showing that persons with Bangladeshi and Pakistani ancestry in Britain had a much greater prevalence (57%) of genetic variations that reduce the effectiveness of clopidogrel. Additionally, these variations are connected to an increased risk of future heart attacks in people using clopidogrel.
This study emphasizes how important it is to consider genetics when identifying who might benefit from taking clopidogrel after a heart attack. Neglecting this factor may undoubtedly unfairly harm some groups, particularly South Asians. They suffer both a greater requirement for antiplatelet therapy and a greater risk of clopidogrel treatment failure due to the elevated frequency of cardiovascular disease among British people of South Asian heritage. This study further emphasizes how the overlapping hazards affecting this community have been hidden by the persistent underrepresentation of South Asians in treatment trials.
One of the research’s supporters and CEO of Barts Charity, Fiona Miller Smith, said:
“At Barts Charity, we are dedicated to supporting medical research that opens the road for better healthcare outcomes for East London’s varied population. We are happy to see the results of this important study, which will surely result in more effective treatment options for this demographic given the elevated prevalence of cardiovascular disease in the South Asian community of East London.