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CYP2C19 polymorphisms and antiplatelet effects of clopidogrel in acute ischemic stroke in China

Dong-mei Jia1, Zhi-bin Chen, Mei-juan Zhang

  • 1Department of Neurology, Drum Tower Hospital of Nanjing Medical University, 321 ZhongShan Rd, Nanjing City, Jiangsu Province, 210008, PR China.

Stroke
|May 4, 2013
PubMed

Insights

CYP2C19 gene variations impact how well patients with acute ischemic stroke respond to clopidogrel. Patients with specific CYP2C19 loss-of-function alleles showed reduced platelet inhibition and worse stroke outcomes.

Area of Science:

  • Pharmacogenomics
  • Neurology
  • Cardiovascular Medicine

Background:

  • Limited research exists on the relationship between genetic variations and clopidogrel response in acute ischemic stroke patients.
  • Understanding these genetic factors is crucial for optimizing antiplatelet therapy.

Purpose of the Study:

  • To investigate the impact of polymorphisms in CYP2C19, CYP3A4, and P2Y12 on clopidogrel response.
  • To determine the effect of these genotypes on the prognosis of patients with acute ischemic stroke.

Main Methods:

  • 259 acute ischemic stroke patients were enrolled and followed for 6 months.
  • Genotyping for CYP2C19, CYP3A4, and P2Y12 was performed.
  • Platelet aggregation, NIHSS, mRS, and vascular events were assessed.

Main Results:

  • Patients with CYP2C19 loss-of-function alleles (*2, *3) exhibited diminished response to clopidogrel, indicated by lower platelet aggregation inhibition.
  • These patients also showed poorer outcomes, evidenced by higher NIHSS and mRS scores at 3 and 6 months.
  • CYP2C19 was identified as an independent predictor of clopidogrel resistance.

Conclusions:

  • CYP2C19 genotype significantly influences clopidogrel efficacy and patient prognosis in acute ischemic stroke.
  • Genetic screening for CYP2C19 may aid in tailoring clopidogrel treatment for stroke patients.
Abstract

Keywords:
CYP2C19 genotypeclopidogrel resistanceischemic strokestroke outcome

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