Prevalence of CYP2C19 Genetic Polymorphisms in Syrian Patients with Acute Coronary Syndrome: A Cross-Sectional Genetic Association Study

Genetic polymorphisms of the CYP2C19 gene play a crucial role in clopidogrel metabolism and contribute to interindividual variability in therapeutic response among patients with acute coronary syndrome (ACS). This cross-sectional genetic association study aimed to determine the prevalence of major CYP2C19 polymorphisms in Syrian patients with ACS. A total of 151 patients were genotyped for CYP2C19 *2 (c.681G>A), *3 (c.636G>A), and *17 (c.-806C>T) using a real-time PCR–based assay. Genotype and allele frequencies were calculated, and Hardy–Weinberg equilibrium was evaluated using Chi-square testing. The allele frequencies of CYP2C19 *2, *3, and *17 were 11.6%, 0.66%, and 22.8%, respectively, with CYP2C19 *1/*1 identified as the most prevalent genotype. Based on CPIC guidelines, patients were classified as poor (1.3%), intermediate (21.2%), normal (44.4%), rapid (26.5%), or ultra-rapid metabolizers (6.6%). These results provide the first baseline data on CYP2C19 genetic variability in Syrian ACS patients and support the clinical relevance of pharmacogenetic testing for personalized antiplatelet therapy.