Observational studyCirculation. Cardiovascular genetics2014
Cytochrome p450 gene variants, race, and mortality among clopidogrel-treated patients after acute myocardial infarction.
Observational study in Circulation. Cardiovascular genetics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- Role of genetic polymorphisms in clopidogrel response variability: a systematic review.Open heart · 2023Pooled it
- The Effect of CYP2C19 and Nongenetic Factors on Clopidogrel Responsiveness in the MENA Region: A Systematic Review.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- A Precision Medicine Approach to Treating Alzheimer's Disease Using Rosiglitazone Therapy: A Biomarker Analysis of the REFLECT Trials.Journal of Alzheimer's disease : JAD · 2021Trial
- CYP2C19 Polymorphism and Platelet Aggregation-Associated Risks in Atrial Fibrillation Patients Undergoing PCI.Clinical and translational science · 2026Article
- Impact of Race on Profiles of Platelet Reactivity and Clinical Outcomes in Clopidogrel-Treated Participants.Clinical pharmacology and therapeutics · 2026Article
- Investigation of Genomic and Transcriptomic Risk Factors of Clopidogrel Response in African Americans.Clinical pharmacology and therapeutics · 2025Article
- Advances in the Clinical Use of Clopidogrel: A Review of Individualized Treatment Strategies and Monitoring Optimization Based on Genetic Polymorphisms.Pharmacogenomics and personalized medicine · 2025Review
- A study of the safety and efficacy of multi-mode NMR-guided double-antiplatelet pretreatment combined with low-dose rtPA in the treatment of acute mild ischemic stroke.Frontiers in neurology · 2025Article
- Genetic Determinants of Response to P2YInterventional cardiology clinics · 2024Review
- Review
- Precision Antiplatelet Therapy after Percutaneous Coronary Intervention (Precision PCI) Registry - Informing optimal antiplatelet strategies.Clinical and translational science · 2024Article
- Article
- PEAR1, PON1, CYP2C19, CYP1A2 and F2R Polymorphisms are Associated with MACE in Clopidogrel-Treated Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.Pharmacogenomics and personalized medicine · 2024Article
- Investigation of genomic and transcriptomic risk factors in clopidogrel response in African Americans.medRxiv : the preprint server for health sciences · 2023Article
- The Role of Global and Local Ancestry on Clopidogrel Response in African Americans.Pacific Symposium on Biocomputing. Pacific Symposium on Biocomputing · 2023Article
- Soluble Epoxide Hydrolase Is Associated with Postprandial Anxiety Decrease in Healthy Adult Women.International journal of molecular sciences · 2022Article
- Identification of a circulating microRNAs biomarker panel for non-invasive diagnosis of coronary artery disease: case-control study.BMC cardiovascular disorders · 2022Article
- Relationship between CYP2C19 Polymorphism and Clopidogrel Resistance in Patients with Coronary Heart Disease and Ischemic Stroke in China.Genetics research · 2022Article
- Effect of chronic unpredicted mild stress-induced depression on clopidogrel pharmacokinetics in rats.PeerJ · 2022Article
- Evaluation of race and ethnicity disparities in outcome studies ofFrontiers in cardiovascular medicine · 2022Review
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundClopidogrel is recommended after acute myocardial infarction but has variable efficacy and safety, in part related to the effect of cytochrome P450 (CYP) polymorphisms on its metabolism. The effect of CYP polymorphisms on cardiovascular events among clopidogrel-treated patients after acute myocardial infarction remains controversial, and no studies to date have investigated the association of CYP variants with outcomes in black patients. METHODS AND
resultsSubjects (2732: 2062 whites; 670 blacks) hospitalized with acute myocardial infarction enrolled in the prospective, multicenter TRIUMPH study were genotyped for CYP polymorphisms. The majority of whites (79%) and blacks (64.4%) were discharged on clopidogrel. Among whites, carriers of the loss-of-function CYP2C19*2 allele had significantly increased 1-year mortality (adjusted hazards ratio [HR]: 1.70; confidence interval [CI]: 1.01-2.86; P=0.046) and a trend toward increased rate of recurrent MI (adjusted HR: 2.10; CI: 0.95-4.63; P=0.066). Among blacks, increased 1-year mortality was associated with the gain-of-function CYP2C19*17 allele (adjusted HR for *1/*17 versus *1/*1: 2.02; CI: 0.92-4.44; *17/*17 versus *1/*1: 8.97; CI: 3.34-24.10; P<0.0001) and the CYP1A2*1C allele (adjusted HR for *1/*1C versus *1/*1: 1.89; CI: 0.85-4.22; *1C/*1C versus *1/*1: 4.96; CI: 1.69-14.56; P=0.014). Bleeding events were significantly more common among black carriers of CYP2C19*17 or CYP1A2*1C.
conclusionsBoth loss-of-function and gain-of-function CYP polymorphisms affecting clopidogrel metabolism are associated with increased mortality among clopidogrel-treated patients after acute myocardial infarction; the specific polymorphism and the putative mechanism vary according to race.
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