DISTRIBUTION OF POLYMORPHISMS OF GENES OF STATINS METABOLISM AND TRANSPORT IN THE LIVER IN PATIENTS WITH CORONARY ARTERY DISEASE ETHNIC UZBEKS WITH SIMVASTATIN INTOLERANCE

Background. It is well-known that in majority of cases treatment with statins can be safe and well tolerated, but in some patients observed statin-induced adverse liver or muscle symptoms - the main reasons for statin discontinuation. Asian ethnicity - is one of the predisposing factors for statin-a...

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Main Authors: A. B. Shek, R. D. Kurbanov, G. J. Abdullayeva, A. V. Nagai, A. A. Abdullaev, S. S. Ahmedova, S. U. Hoshimov, A. V. Ziyaeva
Format: Article
Language:Russian
Published: InterMedservice 2017-03-01
Series:Евразийский Кардиологический Журнал
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Online Access:https://www.heartj.asia/jour/article/view/6
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author A. B. Shek
R. D. Kurbanov
G. J. Abdullayeva
A. V. Nagai
A. A. Abdullaev
S. S. Ahmedova
S. U. Hoshimov
A. V. Ziyaeva
author_facet A. B. Shek
R. D. Kurbanov
G. J. Abdullayeva
A. V. Nagai
A. A. Abdullaev
S. S. Ahmedova
S. U. Hoshimov
A. V. Ziyaeva
author_sort A. B. Shek
collection DOAJ
description Background. It is well-known that in majority of cases treatment with statins can be safe and well tolerated, but in some patients observed statin-induced adverse liver or muscle symptoms - the main reasons for statin discontinuation. Asian ethnicity - is one of the predisposing factors for statin-associated adverse effects. Objective. To study possible effects of CYP3A5 (6986A>G), CYP2C9 (430C>T), CYP2C9 (1075A>C), SLCO1B1 (521T>C) and BCRP (ABCG2, 421C>A) genetic polymorphism on simvastatin tolerance and safety in ethnic Uzbek patients with Coronary Artery Disease (CAD).Material and methods. The prospective case-control research included 100 patients with CAD. Group "case" were 50 patients who demonstrated statin-induced adverse liver effects (transaminase level increases 3 times and more - in 37 cases) or statin-induced elevations in serum CK (of >3*UNL - in 4 cases) at treatment with simvastatin with the dose of 20 mg/day for 3 months of treatment and 13 with myopathy, associated with increased levels of total creatine phosphokinase (CPK) 3 times or more. In 4 patients with adverse effects on the liver, along with an increase in the enzymes, while there was an increase of CPK levels. Control group contained 50 patient with CAD treated with simvastatin with the dose of 20-40 mg/day for one year without side effects. The both groups of patients were similar in gender, age, original index of kidney function and serum CK level. The comparison group consisted of healthy ethnic Uzbeks (n = 41) of comparable age and sex, with the absence of a family history of coronary artery disease. The research was performed by means of PCR-RFLP method.Results. As a whole, all genotypes (except for CYP2C9 * 2 in patients) were in Hardy-Weinberg equilibrium. Among patients with simvastatin intolerance, compared to the control group, the following genotypes were observed more frequently with high level of confidence: CYP3A5 *3/*3, compared to genotype variants *1/*3 and *1/*1 (OR 9.33; 95% CI 3,37-25,9; P = 0.0001) and BCRP CA (patients with BCRP CC genotype were not observed among those examined) (OR 3.22; 95% CI 1,258,30, P = 0.024).Conclusions. Genotypes CYP3A5 *3/*3 (6986A>G) and BCRP CA (ABCG2, 421C>A) are accompanied with the increase of statin-induced adverse effects in ethnic Uzbek patients with Coronary artery disease.
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spelling doaj-art-d5621dd02302495b8d0a2ffd4fd4e5702025-08-20T03:58:59ZrusInterMedserviceЕвразийский Кардиологический Журнал2225-16852305-07482017-03-0101243110.38109/2225-1685-2017-1-24-315DISTRIBUTION OF POLYMORPHISMS OF GENES OF STATINS METABOLISM AND TRANSPORT IN THE LIVER IN PATIENTS WITH CORONARY ARTERY DISEASE ETHNIC UZBEKS WITH SIMVASTATIN INTOLERANCEA. B. Shek0R. D. Kurbanov1G. J. Abdullayeva2A. V. Nagai3A. A. Abdullaev4S. S. Ahmedova5S. U. Hoshimov6A. V. Ziyaeva7JSC Republican Specialized Center of CardiologyJSC Republican Specialized Center of CardiologyJSC Republican Specialized Center of CardiologyJSC Republican Specialized Center of CardiologyInstitute of Genetics and Experimental Biology of Plants of the Academy of Sciences of UzbekistanJSC Republican Specialized Center of CardiologyJSC Republican Specialized Center of CardiologyJSC Republican Specialized Center of CardiologyBackground. It is well-known that in majority of cases treatment with statins can be safe and well tolerated, but in some patients observed statin-induced adverse liver or muscle symptoms - the main reasons for statin discontinuation. Asian ethnicity - is one of the predisposing factors for statin-associated adverse effects. Objective. To study possible effects of CYP3A5 (6986A>G), CYP2C9 (430C>T), CYP2C9 (1075A>C), SLCO1B1 (521T>C) and BCRP (ABCG2, 421C>A) genetic polymorphism on simvastatin tolerance and safety in ethnic Uzbek patients with Coronary Artery Disease (CAD).Material and methods. The prospective case-control research included 100 patients with CAD. Group "case" were 50 patients who demonstrated statin-induced adverse liver effects (transaminase level increases 3 times and more - in 37 cases) or statin-induced elevations in serum CK (of >3*UNL - in 4 cases) at treatment with simvastatin with the dose of 20 mg/day for 3 months of treatment and 13 with myopathy, associated with increased levels of total creatine phosphokinase (CPK) 3 times or more. In 4 patients with adverse effects on the liver, along with an increase in the enzymes, while there was an increase of CPK levels. Control group contained 50 patient with CAD treated with simvastatin with the dose of 20-40 mg/day for one year without side effects. The both groups of patients were similar in gender, age, original index of kidney function and serum CK level. The comparison group consisted of healthy ethnic Uzbeks (n = 41) of comparable age and sex, with the absence of a family history of coronary artery disease. The research was performed by means of PCR-RFLP method.Results. As a whole, all genotypes (except for CYP2C9 * 2 in patients) were in Hardy-Weinberg equilibrium. Among patients with simvastatin intolerance, compared to the control group, the following genotypes were observed more frequently with high level of confidence: CYP3A5 *3/*3, compared to genotype variants *1/*3 and *1/*1 (OR 9.33; 95% CI 3,37-25,9; P = 0.0001) and BCRP CA (patients with BCRP CC genotype were not observed among those examined) (OR 3.22; 95% CI 1,258,30, P = 0.024).Conclusions. Genotypes CYP3A5 *3/*3 (6986A>G) and BCRP CA (ABCG2, 421C>A) are accompanied with the increase of statin-induced adverse effects in ethnic Uzbek patients with Coronary artery disease.https://www.heartj.asia/jour/article/view/6cyp2c9slco1b1bcrpstatin intolerancepolymorphisms of genes cyp3a5cyp2c9slco1b1bcrp
spellingShingle A. B. Shek
R. D. Kurbanov
G. J. Abdullayeva
A. V. Nagai
A. A. Abdullaev
S. S. Ahmedova
S. U. Hoshimov
A. V. Ziyaeva
DISTRIBUTION OF POLYMORPHISMS OF GENES OF STATINS METABOLISM AND TRANSPORT IN THE LIVER IN PATIENTS WITH CORONARY ARTERY DISEASE ETHNIC UZBEKS WITH SIMVASTATIN INTOLERANCE
Евразийский Кардиологический Журнал
cyp2c9
slco1b1
bcrp
statin intolerance
polymorphisms of genes cyp3a5
cyp2c9
slco1b1
bcrp
title DISTRIBUTION OF POLYMORPHISMS OF GENES OF STATINS METABOLISM AND TRANSPORT IN THE LIVER IN PATIENTS WITH CORONARY ARTERY DISEASE ETHNIC UZBEKS WITH SIMVASTATIN INTOLERANCE
title_full DISTRIBUTION OF POLYMORPHISMS OF GENES OF STATINS METABOLISM AND TRANSPORT IN THE LIVER IN PATIENTS WITH CORONARY ARTERY DISEASE ETHNIC UZBEKS WITH SIMVASTATIN INTOLERANCE
title_fullStr DISTRIBUTION OF POLYMORPHISMS OF GENES OF STATINS METABOLISM AND TRANSPORT IN THE LIVER IN PATIENTS WITH CORONARY ARTERY DISEASE ETHNIC UZBEKS WITH SIMVASTATIN INTOLERANCE
title_full_unstemmed DISTRIBUTION OF POLYMORPHISMS OF GENES OF STATINS METABOLISM AND TRANSPORT IN THE LIVER IN PATIENTS WITH CORONARY ARTERY DISEASE ETHNIC UZBEKS WITH SIMVASTATIN INTOLERANCE
title_short DISTRIBUTION OF POLYMORPHISMS OF GENES OF STATINS METABOLISM AND TRANSPORT IN THE LIVER IN PATIENTS WITH CORONARY ARTERY DISEASE ETHNIC UZBEKS WITH SIMVASTATIN INTOLERANCE
title_sort distribution of polymorphisms of genes of statins metabolism and transport in the liver in patients with coronary artery disease ethnic uzbeks with simvastatin intolerance
topic cyp2c9
slco1b1
bcrp
statin intolerance
polymorphisms of genes cyp3a5
cyp2c9
slco1b1
bcrp
url https://www.heartj.asia/jour/article/view/6
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