Association of ABCB1 gene polymorphisms with aspirin or clopidogrel resistance in ischemic stroke: a meta-analysis

Ischemic stroke (IS) is a major public health concern worldwide. In this study, we aimed to investigate the relationship between ABCB1 gene polymorphisms and antiplatelet resistance in patients with IS.

We performed a comprehensive search of the PubMed, China National Knowledge Infrastructure, Web of Science, and WANFANG databases for articles published until February 2024. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were used to measure the association between ABCB1 polymorphisms and antiplatelet resistance in patients with IS. All the statistical analyses were performed using STATA version 11.0.

Eleven studies containing 2,228 cases and 2,556 controls met the inclusion criteria. Our results showed that aspirin resistance in patients with IS was significantly correlated with the polymorphism of ABCB1 rs1045642 (Allele model: OR=1.5, 95% CI [1.10, 2.05], P=0.010; Homozygote model: OR=2.02, 95% CI [1.01, 4.05], P=0.047; Heterozygote model: OR=1.37, 95% CI [0.91, 2.08], P=0.132; Dominant model: OR=1.75, 95% CI [1.09, 2.81], P=0.021; Recessive model: OR=1.61, 95% CI [1.01, 2.57], P=0.045). Meanwhile, we found that ABCB1 rs1045642 polymorphism might be significantly associated with clopidogrel resistance in IS (A. Homozygote model: OR=3.35, 95% CI [1.99, 5.63], P=0.000; B. Heterozygote model: OR=0.81, 95% CI [0.54, 1.21], P=0.895; C. Dominant model: OR=1.41, 95% CI [0.59, 3.36], P=0.435; D. Recessive model: OR=3.43, 95% CI [2.14, 5.51], P=0.000).

This meta-analysis suggests a potential link between ABCB1 rs1045642 polymorphism and resistance to clopidogrel or aspirin in patients with IS.