A new genetic study has found that cardiovascular medication used to prevent heart attacks is much less likely to benefit people of Bangladeshi and Pakistani ancestry than people of European descent.
Scientists at Queen Mary University in London discovered that clopidogrel, a commonly prescribed medication used to prevent further heart attacks after an initial event, was ineffective in 57 per cent of British South Asians.
The research funded by the National Institute for Health and Care Research (NIHR), Barts Biomedical Research Centre and Barts Charity and published in JACC: Advances highlights the need to understand how medications affect different racial groups to ensure everyone can access effective treatments.
Clopidogrel is a commonly prescribed medication which reduces the risk of blood clots forming. It needs to be activated in the body to be effective. Previous studies show that around 30 per cent of people of European descent have a genetic variant that reduces or prevents medication activation. Despite high rates of cardiovascular disease in UK South Asian populations, genetic variants and their effects have not been studied in this population.
Using data from the Genes and Health cohort, the researchers examined data from 44,396 British people with Bangladeshi and Pakistani ancestry, linking genetic data with a participant’s long-term health records.
The researchers found that 57 per cent of participants had a common genetic variant, meaning they could not activate the clopidogrel medication. But two out of three participants who had a heart attack received clopidogrel.
The long-term health records show that participants with the genetic variant, which made them unable to utilise clopidogrel, were more than three times more likely to have recurrent heart attacks. The researchers suggest this may be related to the failure of the medication in this population.
Dr Emma Magavern, lead author from Queen Mary University of London, said: ‘This study highlights the importance of using genetics to determine who can benefit from clopidogrel after a heart attack, and how not doing so is likely to disproportionately disadvantage specific groups, such as South Asians.’
‘British peoples of South Asian ancestry suffer from high rates of cardiovascular disease and therefore have both a high risk of needing an antiplatelet medication and a high risk of treatment failure with clopidogrel.’
The researchers commented that this study also illustrates how systemic under-representation of South Asians in therapeutics trials has obscured the intersection of risks impacting this community.
