Evidence map›Paper›PMID 32345264›Full record

Observational studyBMC neurology2020

Variants in clopidogrel-relevant genes and early neurological deterioration in ischemic stroke patients receiving clopidogrel.

Xingyang Yi, Qiang Zhou, Yongyin Zhang, Ju Zhou, Jing Lin

Registry-linked trialAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06037889 (Efficacy and Safety of Tirofiban in Patients With Acute Branch Atheromatous Disease), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT06037889 phase3completednot on this mapstarted 2023, after this paper: background citation

Efficacy and Safety of Tirofiban in Patients With Acute Branch Atheromatous Disease (BAD)- Related Stroke (BRANT)

TypeinterventionalSponsorPeking Union Medical College HospitalRan2023 to 2026Enrolled516ConditionsBranch Atheromatous DiseaseArmsTirofiban, Aspirin tablet, Clopidogrel tablet
3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Xingyang YiDepartment of Neurology, the People's Hospital of Deyang City, Deyang, 618000, Sichuan, China.
Qiang ZhouDepartment of Neurology, the Third Affiliated Hospital of Wenzhou Medical University, 108 Wanson Road, Ruian City, Wenzhou, 325200, Zhejiang, China. zhouqiang5613@163.com.
Yongyin ZhangDepartment of Neurology, the Third Affiliated Hospital of Wenzhou Medical University, 108 Wanson Road, Ruian City, Wenzhou, 325200, Zhejiang, China.
Ju ZhouDepartment of Neurology, the People's Hospital of Deyang City, Deyang, 618000, Sichuan, China.
Jing LinDepartment of Neurology, the Third Affiliated Hospital of Wenzhou Medical University, 108 Wanson Road, Ruian City, Wenzhou, 325200, Zhejiang, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly neurological deterioration (END) is common in acute ischemic stroke (IS). However, the underlying mechanisms for END are unclear. The aim of this study was to evaluate the associations of 16 variants in clopidogrel-relevant genes and interactions among these variants with END in acute IS patients receiving clopidogrel treatment.

methodsWe consecutively enrolled 375 acute IS patients between June 2014 and January 2015. Platelet aggregation was measured on admission and after the 7-10 days of clopidogrel treatment. The 16 variants in clopidogrel-relevant genes were examined using mass spectrometry. The primary outcome was END within the 10 days of admission. Gene-gene interactions were analyzed by generalized multifactor dimensionality reduction (GMDR) methods.

resultsAmong the 375 patients, 95 (25.3%) patients developed END within the first 10 days of admission. Among the 16 variants, only CYP2C19*2 (rs4244285) AA/AG was associated with END using single-locus analytical approach. GMDR analysis revealed that there was a synergistic effect of gene-gene interactions among CYP2C19*2 rs4244285, P2Y12 rs16863323, and GPIIIa rs2317676 on the risk for END. The high-risk interactions among the three variants were associated with the higher platelet aggregation and independent predictor for END after adjusting for the covariates (hazard ratio: 2.82; 95% confidence interval: 1.36-7.76; P = 0.003).

conclusionsEND is very common in patients with acute IS. The mechanisms leading to END are most likely multifactorial. Interactions among CYP2C19*2 rs4244285, P2Y12 rs16863323, and GPIIIa rs2317676 may confer a higher risk for END. It was very important to modify clopidogrel therapy for the patients carrying the high-risk interactive genotypes. CLINICAL TRIAL REGISTRATION INFORMATION: The study described here is registered at http://www.chictr.org/ (unique Identifier: ChiCTR-OCH-14004724). The date of trial registration was May 30, 2014.

Indexed as

RecurrenceBrain IschemiaClopidogrelCytochrome P-450 CYP2C19Epistasis, GeneticGenotypeHumansIntegrin beta3Platelet AggregationPlatelet Aggregation InhibitorsPolymorphism, Single NucleotideProspective StudiesReceptors, Purinergic P2Y12StrokeClopidogrelCYP2C19 protein, humanCytochrome P-450 CYP2C19Integrin beta3P2RY12 protein, humanPlatelet Aggregation InhibitorsReceptors, Purinergic P2Y12ClopidogrelEarly neurological deteriorationGenetic polymorphismGlycoprotein IIIaIschemic strokePharmacogeneticsPlatelet membrane receptor

Identifiers

PMID32345264
PMCPMC7187527

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.