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Personalized antiplatelet therapy based on clopidogrel/aspirin resistance tests in acute ischemic stroke and

Jiajing Wang1, Mengqi Han1, Jie Kuang2

  • 1Medical Big Data Center, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang 330006, PR China; Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 461BaYi Road, Nanchang 330006, PR China.

Contemporary Clinical Trials
|July 18, 2021
PubMed

Insights

Personalized antiplatelet therapy using CYP2C19 genotype and urine 11-dhTxB2 tests can improve outcomes for acute ischemic stroke (AIS) and transient ischemic attack (TIA) patients with resistance. This approach offers a new strategy for effective antiplatelet treatment.

Area of Science:

  • Cardiology
  • Neurology
  • Pharmacogenomics

Background:

  • Clopidogrel and aspirin are standard antiplatelet therapies for acute ischemic stroke (AIS) and transient ischemic attack (TIA).
  • Clopidogrel resistance (CR) and aspirin resistance (AR) reduce the efficacy of antiplatelet therapy in AIS/TIA patients.
  • Current guidelines lack personalized treatment strategies for patients exhibiting CR and/or AR.

Purpose of the Study:

  • To assess the effectiveness of personalized antiplatelet therapy in AIS/TIA patients with CR and/or AR.
  • To evaluate the impact of tailoring antiplatelet treatment based on CYP2C19 genotype and urine 11-dhTxB2 tests.
  • To provide evidence for developing personalized antiplatelet therapy guidelines.

Main Methods:

  • A multi-center randomized controlled trial involving patients with AIS/TIA from 14 hospitals.
  • Random assignment of participants to either a personalized therapy group (based on CYP2C19 genotype/urine 11-dhTxB2 tests) or a control group.
  • Collection of comprehensive clinical data and assessment of outcomes including stroke recurrence, mRS score, bleeding events, and mortality over a 12-month follow-up period.

Main Results:

  • This section is to be filled once the study is completed and results are available.

Conclusions:

  • Personalized antiplatelet therapy holds promise for improving clinical outcomes in AIS/TIA patients with resistance.
  • CYP2C19 genotype and urine 11-dhTxB2 testing can guide precise antiplatelet treatment strategies.
  • Further research is needed to establish definitive guidelines for personalized antiplatelet therapy in stroke patients.
Abstract

Keywords:
Ischemic strokePersonalized antiplatelet therapyPrognosisRandomized controlled trialTransient ischemic attack

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