ArticleJournal of the Chinese Medical Association : JCMA2019
Investigating CYP2C19 loss-of-function allele statuses and their association with stroke of different etiologies in a Taiwanese population.
Article in Journal of the Chinese Medical Association : JCMA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed.
- Clinical outcomes of generic versus brand-name clopidogrel for secondary prevention in patients with acute myocardial infarction: A nationwide cohort study.Clinical and translational science · 2023Article
- The 2023 Taiwan Stroke Society Guidelines for the management of patients with intracranial atherosclerotic disease.Journal of the Chinese Medical Association : JCMA · 2023Article
- Baseline P2Y12 reactivity, kidney function, and CYP2C19 genotype determine clopidogrel responsiveness in acute stroke.Scientific reports · 2023Article
- CYP2C19 loss-of-function is associated with increased risk of hypertension in a Hakka population: a case-control study.BMC cardiovascular disorders · 2023Article
- Differences in the Proportion of CYP2C19 Loss-of-Function Between Cerebral Infarction and Coronary Artery Disease Patients.International journal of general medicine · 2023Article
- Article
- A HANC Risk Stratification Score for Antiplatelet Therapy Optimization with Low-Dose Prasugrel in Taiwanese Acute Coronary Syndrome Patients from the Switch Study.Acta Cardiologica Sinica · 2022Article
- Prasugrel switching from clopidogrel after percutaneous coronary intervention for acute coronary syndrome in Taiwanese patients: an analysis of safety and efficacy.Cardiovascular intervention and therapeutics · 2022Article
- CYP2C19 loss-of-function alleles predicts clinical outcomes in East Asian patients with acute myocardial infarction undergoing percutaneous coronary intervention and stenting receiving clopidogrel.Frontiers in cardiovascular medicine · 2022Article
- Clopidogrel Use and CYP2C19 Genotypes in Patients Undergoing Vascular Intervention Procedure: A Hospital-Based Study.Pharmacogenomics and personalized medicine · 2022Article
- Efficacy and safety of clopidogrel and aspirin do not differ in patients with stable ischemic stroke.Journal of the Chinese Medical Association : JCMA · 2020Article
- Association between CYP2C19 gene polymorphisms and lipid metabolism in Chinese patients with ischemic stroke.The Journal of international medical research · 2020Article
- CYP2C19 loss-of-function alleles: A common but overlooked problem associated with clopidogrel resistance.Journal of the Chinese Medical Association : JCMA · 2019Article
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Abstract
backgroundCYP2C19 loss-of-function single-nucleotide polymorphisms (SNPs) are associated with poor responses of clopidogrel in secondary prevention of ischemic stroke (IS). It is still unclear whether these SNPs, which may result in poor cytochrome P450 2C19 (CYP2C19) enzymatic activity, affect the occurrence of IS and its subtypes. The present study evaluated the relationship between the CYP2C19 loss-of-function alleles and IS.
methodsEight hundred sixty-eight patients with IS and 557 nonstroke (NS) control individuals were prospectively recruited. Stroke etiologies, including large-artery atherosclerosis (LAA), cardioembolism (CE), and small-vessel occlusion (SVO), were determined. The two most common CYP2C19 loss-of-function alleles worldwide, CYP2C19*2 and CYP2C19*3, were investigated by genotyping. Patients with two loss-of-function alleles of the CYP2C19 genes were classified as poor metabolizers.
resultsOur population has a high frequency of CYP2C19 loss-of-function alleles, mostly contributed by CYP2C19*2, being present in 51.3% to 57.5% of patients with IS of different etiologies and 53.1% of NS individuals. The proportions of CYP2C19 poor metabolizers within NS group and each IS group with disparate etiology are similar (NS 73 [13.1%]; LAA 44 [14.2%], p = 0.623; CE 26 [14.0%], p = 0.541; SVO 38 [13.3%], p = 0.443). Nevertheless, the frequencies of CYP2C19*3 allele were different among the NS and different IS subgroups. Multivariate analyses adjusting for age, sex, and vascular risk factors revealed that CYP2C19*3 allele was a protective factor for SVO (odds ratio [OR] = 0.5, 95% confidence interval [CI] = 0.3 to 0.9, p = 0.015 [vs NS], OR = 0.5, 95% CI = 0.3 to 0.8, p = 0.010 [vs LAA and CE]).
conclusionThe CYP2C19 poor metabolizer is not associated with IS and its subtypes. Furthermore, CYP2C19*3 may be a protective factor for SVO and its mechanism warrants further investigation.
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