Abstract
The CYP2C19 gene plays a detrimental role in the metabolism of clopidogrel. This study aimed to investigate the association between CYP2C19 polymorphisms and the clinical efficacy of clopidogrel therapy in patients who have undergone carotid artery stenting (CAS). CYP2C19 genotype screening was performed on 959 ischemic stroke patients. Of these patients, 241 who had undergone CAS were enrolled in the study. They were all followed up for 1 year after stent surgery, and the primary clinical end-points were ischemic events. The frequencies of the CYP2C19*2 and *3 alleles among the 959 patients were 31.80% and 5.06%, respectively. Regarding the 241 participants who had undergone CAS, multivariate Cox regression analysis showed that the CYP2C19 loss-of-function (LOF) alleles (*2 and *3) were risk factors for post-CAS prognosis. Within 1 year of follow-up, the patients carrying the CYP2C19 LOF alleles were more likely to experience ischemic events than those carrying none. The occurrence of ischemic events did not significantly differ between the *2 and *3 allele carriers. Our results suggest that CYP2C19 LOF alleles (*2 and *3) significantly impact the prognosis of patients on clopidogrel therapy after CAS and that the CYP2C19*2 and CYP2C19*3 alleles have the same effects on prognosis.
Highlights
LOF alleles have a reduced response to clopidogrel and experience a significantly poorer outcome, according to modified Rankin Scale scores, at 3 and 6 months after stroke[24]
We found that 61.21% of the patients carried at least one CYP2C19 LOF allele, including 12.52% patients carrying 2 LOF alleles
We first confirmed the association between CYP2C19 polymorphisms and the clinical efficacy of clopidogrel therapy in patients who had undergone carotid artery stenting (CAS) in China
Summary
LOF alleles have a reduced response to clopidogrel and experience a significantly poorer outcome, according to modified Rankin Scale (mRS) scores, at 3 and 6 months after stroke[24]. It is not yet clear whether the CYP2C19 LOF alleles (*2 and *3) have an impact on the clinical efficacy of clopidogrel therapy after CAS. We selected patients with CYP2C19 LOF alleles who had undergone CAS for enrollment to determine the relationship between CYP2C19 gene polymorphisms and the clinical efficacy of clopidogrel therapy after CAS.
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