The association of CYP2C19 LoF alleles with adverse clinical outcomes in stroke patients taking clopidogrel: An updated meta-analysis
Issued Date
2024-04-01
Resource Type
ISSN
17528054
eISSN
17528062
Scopus ID
2-s2.0-85189312334
Journal Title
Clinical and Translational Science
Volume
17
Issue
4
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical and Translational Science Vol.17 No.4 (2024)
Suggested Citation
Biswas M., Hossain M.S., Ahmed Rupok T., Hossain M.S., Sukasem C. The association of CYP2C19 LoF alleles with adverse clinical outcomes in stroke patients taking clopidogrel: An updated meta-analysis. Clinical and Translational Science Vol.17 No.4 (2024). doi:10.1111/cts.13792 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/97926
Title
The association of CYP2C19 LoF alleles with adverse clinical outcomes in stroke patients taking clopidogrel: An updated meta-analysis
Corresponding Author(s)
Other Contributor(s)
Abstract
The aggregated risk of recurrent stroke in stroke/transient ischemic attack (TIA) patients carrying CYP2C19 LoF alleles who take clopidogrel has not been investigated recently, and the available research is limited. This study aimed to perform an updated meta-analysis to assess the association between CYP2C19 LoF alleles and the risk of recurrent stroke in patients taking clopidogrel. Databases were searched for the literature on eligible studies. The end points were recurrent stroke, composite vascular events, and bleeding events. Odds ratios (ORs) were calculated using RevMan software, where p < 0.05 was considered statistically significant. Patients carrying CYP2C19 LoF alleles who were treated with clopidogrel had a significantly increased risk of recurrent ischemic stroke compared with non-carriers (OR 2.18, 96% CI 1.80–2.63; p < 0.00001). The risk of recurrent stroke was only significantly different in Asian patients (OR 2.29, 96% CI 1.88–2.80; p < 0.00001) but not in patients of other ethnicities; however, there were a limited number of studies in other ethnic groups. Both observational studies (OR 2.83, 96% CI 2.20–3.65; p < 0.00001) and RCTs (OR 1.48, 96% CI 1.10–1.98; p = 0.009) found associations with a significantly increased risk of recurrent ischemic stroke. Asian stroke patients or TIA patients carrying CYP2C19 LoF alleles and taking clopidogrel were at a significantly higher risk of recurrent ischemic stroke than non-carriers. Significantly increased risk of recurrent ischemic stroke was found in both observational studies and RCTs.