# Adopting a Precision Medicine Paradigm in Puerto Rico: leveraging ancestral diversity to identify predictors of clopidogrel response in Caribbean Hispanics

> **NIH NIH U54** · UNIVERSITY OF PUERTO RICO MED SCIENCES · 2020 · $373,768

## Abstract

PROJECT SUMMARY
 Despite the substantial work in cardiovascular pharmacogenomics published over the past decade, a
fundamental gap remains in understanding whether the genomic diversity of Caribbean Hispanics accounts for
high inter-individual variability of clinical outcomes to preventive dual antiplatelet therapy (DAPT) with
clopidogrel. Caribbean Hispanics are disproportionately affected by cardio-metabolic disorders, but with a
limited expectation of benefits from existing genomic-based algorithms. We will focus on clopidogrel to develop
urgently-needed genomic-driven prescription guidelines for this population. To this purpose, we propose to
perform the first ever GWAS of a pharmacogenetically actionable prescription drug in Caribbean Hispanics.
Our proposal will also take a novel approach to definitively assess the admixture component and is also highly
practical for the development of a clinical decision support (CDS) tool. We will implement a treatment algorithm
to guide DAPT in Caribbean Hispanics and will create a repository of genomic DNAs and fully annotated
clinical and genomic dataset from Caribbean Hispanics with cardiovascular diseases. Shaped by strong
preliminary data, we will test the following hypothesis:
There are unknown genetic variants that uniquely contribute to clopidogrel responsiveness in Caribbean
Hispanics to such extent that a developed CDS tool that incorporates personal ethno-specific genotypes and
ex vivo pharmacodynamic (PD) testing will help enable more precise recommendations for optimizing medical
outcomes to antiplatelet therapy in this population.
 The study will be conducted over 5 years in 1,000 cardiovascular patients treated with clopidogrel for
secondary prevention of thromboembolic events. It is expected that this study advances the adoption of a
Precision Medicine (PM) paradigm for the benefit of Hispanic patients. The richer genetic variance in Latinos is
likely to contribute substantially to variability in response to drug treatments, a component that will be missed
by traditional studies in homogeneous populations. This addressable oversight is of great concern, since it will
tend to exacerbate the healthcare disparity already experienced by Hispanic populations in the US. Hispanics
have been largely excluded from PM initiatives, which increase dramatically the disparities in translating
benefits from new findings in pharmacogenomics to this medically underserved population, exacerbating the
existing inequity in healthcare services. Accordingly, the proposed research will expand our current
understanding on the pharmacogenomics of clopidogrel. Advancing knowledge in the under-investigated area
of pharmacogenetics in minority populations will generate results that apply to personalize DAPT in the wider
population as it moves, inevitably, toward increasing heterogeneity through admixed genomes.

## Key facts

- **NIH application ID:** 9956624
- **Project number:** 5U54MD007600-34
- **Recipient organization:** UNIVERSITY OF PUERTO RICO MED SCIENCES
- **Principal Investigator:** Jorge Duconge
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $373,768
- **Award type:** 5
- **Project period:** 1997-09-01 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9956624

## Citation

> US National Institutes of Health, RePORTER application 9956624, Adopting a Precision Medicine Paradigm in Puerto Rico: leveraging ancestral diversity to identify predictors of clopidogrel response in Caribbean Hispanics (5U54MD007600-34). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9956624. Licensed CC0.

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