Evidence map›Paper›PMID 32504182›Full record

Observational studyEuropean journal of clinical pharmacology2020

Age-dependent association of CYP2C19 polymorphisms with clinical outcome of clopidogrel therapy in minor stroke patients with large-artery atherosclerosis.

Dapeng Wang, Lingjie Li, Jianhua Jiang, Quanquan Zhang, Meirong Liu, Yang Liu, Hongru Zhao, Qi Fang

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in European journal of clinical pharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 89% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. 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

8 authors at 2 institutions in 2 countries.

Dapeng WangDepartment of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
Lingjie LiDepartment of HLA Laboratory, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
Jianhua JiangDepartment of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
Quanquan ZhangDepartment of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
Meirong LiuDepartment of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
Yang LiuDepartment of Neurology, Saarland University, 66421, Homburg, Germany.
Hongru ZhaoDepartment of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China. zhaohongru_soochow@163.com.ORCID http://orcid.org/0000-0001-5744-417X
Qi FangDepartment of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China. fangqi_008@126.com.
Soochow University · CNSaarland University · DE

Funding

Basic Research Program of Jiangsu Province BK20170362Young Scientists Fund 81701051
6 · The paper itself

Abstract

purposePrevious studies on the association between CYP2C19 polymorphisms and therapeutic outcome of clopidogrel in stroke patients are inconclusive. We aimed to investigate the impact of CYP2C19 polymorphisms on therapeutic efficacy of clopidogrel in both young and old minor stroke patients associated with large-artery atherosclerosis (LAA).

methodsA total of 510 eligible patients were enrolled between April 2015 and April 2018. During 1 year of follow-up, the modified Rankin Scale (mRS) was recorded. Statistical comparisons were performed using Pearson's chi squared test, Mann Whitney U test, and the Breslow-Day test to determine the effects of CYP2C19 polymorphisms on clinical outcome in different age strata. Multivariate binary logistic analysis was used to examine the potential prognostic predictors for clinical outcome. Model fitness was detected with Hosmer-Lemeshow test.

resultsSixty years old was identified as the optimal cutoff age for CYP2C19 polymorphisms to affect the clinical outcome of clopidogrel therapy in LAA-associated minor stroke patients (OR = 1.67; 95% CI 1.08-2.58). Comparisons of baseline characteristics between patients with favorable and poor outcome indicated the correlation between CYP2C19 loss-of-function (LOF) allele and poorer clinical outcome in ≤ 60-year-old patients (OR = 4.29; 95% CI 1.68-10.93). The heterogeneity test showed a presence of interaction between age and CYP2C19 LOF (OR = 3.75; 95% CI 1.30-10.81). The logistic analyses further suggested that CYP2C19 LOF predicted poor clinical outcome in ≤ 60-year-old but not in > 60-year-old LAA-associated minor stroke patients receiving clopidogrel for the second prevention.

conclusionsCarriage of the CYP2C19 LOF allele may prevent expected clinical outcome during clopidogrel therapy in young LAA-associated minor stroke patients, whereas not in older patients.

Indexed as

AgedAge FactorsAllelesAtherosclerosisClopidogrelCytochrome P-450 CYP2C19FemaleFollow-Up StudiesHumansMaleMiddle AgedPlatelet Aggregation InhibitorsPolymorphism, GeneticProspective StudiesStrokeTreatment OutcomeClopidogrelCYP2C19 protein, humanCytochrome P-450 CYP2C19Platelet Aggregation InhibitorsCytochrome P450 enzymesGenetic polymorphismPlateletsStroke

Identifiers

PMID32504182
OpenAlexW3033287433

What OpenQuestion holds

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Registered trials

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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.