Thesis (M.Sc.) - Cairo University - Faculty of Pharmacy - Department of Pharmaceutics

Statins (HMG-CoA reductase inhibitors) are today accepted as the treatment of choice for lowering low density lipoprotein cholesterol (LDL-C) in the vast majority of individuals with increased risk for cardiovascular disease (CVD) and associated mortality. One of regularly used statins atorvastatin is mainly metabolized by cytochrome P450 (CYP) 3A4 enzyme, genetic variation within the CYP3A4 gene may lead to variation in CYP3A4 activity and, in turn, to the difference in the metabolism and, ultimately, the variable response of atorvastatin. The aim of this study is to determine whether the CYP3A4*1G gene polymorphisms affect lipid-lowering efficacy of atorvastatin (80 mg / day) after 4 weeks of treatment and prevalence of these polymorphisms in the Egyptian patients. Patients and methods In a prospective observational non-intervention randomized open labeled study, forty eight critically cardiac ill Egyptian patients admitted with an acute coronary syndrome (myocardial infarction) who were susceptible to intensive atorvastatin dose (80 mg) treatment were selected during the period from July 2011 to May 2015 to be enrolled in the present study. Genomic DNA was extracted from WBCs and CYP3A4*1G genotyping was done using a polymerase chain reaction restriction fragment length polymorphism (PCR- RFLP) analysis. The fragments containing 1/1, 1/1G and 1G/1G polymorphism were amplified. Serum triglyceride (TG), total cholesterol (TC), and high density lipoprotein cholesterol (HDL-C) levels were determined at baseline and after 4 weeks of treatment by enzymatic assays

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