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Published on: April 1, 2019

Meta-analysis of effects of ABCB1 polymorphisms on clopidogrel response among patients with coronary artery disease

Yajing Zhai1, Hairong He2, Xiancang Ma2

  • 1Department of Pharmacy, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China.

European Journal of Clinical Pharmacology
|April 6, 2017
PubMed

Insights

The ABCB1 C3435T polymorphism may increase bleeding risk in Asian patients taking clopidogrel. This genetic variation

Area of Science:

  • Pharmacogenetics
  • Molecular Epidemiology
  • Clinical Pharmacology

Background:

  • Clopidogrel's antiplatelet efficacy varies significantly among patients.
  • The ABCB1 C3435T polymorphism is a potential factor influencing clopidogrel response, but evidence is conflicting.

Purpose of the Study:

  • To conduct a PRISMA-compliant meta-analysis.
  • To precisely evaluate the association between ABCB1 C3435T polymorphism and clopidogrel's clinical efficacy.

Main Methods:

  • Searched PubMed and EMBASE databases up to October 2016.
  • Included 28 studies with 23,243 patients.
  • Used odds ratios (OR), standard mean difference (SMD), and 95% confidence intervals (CI) for analysis.

Main Results:

  • No overall association found between ABCB1 polymorphisms and the primary outcome.
  • Subgroup analysis indicated C3435T mutation reduced platelet activity in dominant and heterozygous models (LTA assay), but lacked robustness.
  • Significant association observed between C3435T polymorphism and increased bleeding risk in Asian patients (dominant, homozygous, heterozygous models).

Conclusions:

  • ABCB1 C3435T polymorphism may elevate bleeding risk in Asian patients receiving clopidogrel.
  • Further basic genetic pharmacology studies are needed to confirm this association.
Abstract

Keywords:
ABCB1ClopidogrelMeta-analysisPolymorphism

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