SynthesisClinical and translational science2024
The association of CYP2C19 LoF alleles with adverse clinical outcomes in stroke patients taking clopidogrel: An updated meta-analysis.
Synthesis in Clinical and translational science, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- CYP2C19 genotype testing for clopidogrel: A guideline developed by the UK Centre of Excellence in Regulatory Science and Innovation in Pharmacogenomics (CERSI-PGx).British journal of clinical pharmacology · 2026Guideline
- The association of CYP2C19 LoF alleles with adverse clinical outcomes in stroke patients taking clopidogrel: An updated meta-analysis.Clinical and translational science · 2024Pooled it
- Transradial and Transfemoral Approaches for Vertebral Artery Stenting: A Single-Center, Prospective, Non-Inferiority Comparison.Medical science monitor : international medical journal of experimental and clinical research · 2024Trial
- CYP2C19 Genotyping to Guide Clopidogrel Prescribing for Neurovascular Indications: A Survey of Institutional Approaches.Clinical pharmacology and therapeutics · 2026Article
- A new first line choice? Has clopidogrel superseded aspirin for secondary prevention following selected minor ischaemic strokes?Internal medicine journal · 2026Article
- The association of ABCB1, CYP2C19 and CYP2C9 combined activity with clopidogrel resistance in patients with recurrent ischemic stroke.The pharmacogenomics journal · 2026Article
- Paradoxical myocardial infarction risk with dual antiplatelet therapy in East Asian ischaemic stroke: a nationwide real-world cohort study and pharmacogenomic risk prediction model.Therapeutic advances in neurological disorders · 2026Article
- Risk factors for Post-PCI cardiovascular events in coronary artery disease patients treated with clopidogrel combined with aspirin.Frontiers in pharmacology · 2026Article
- Comprehensive Molecular Evaluation of Transcription Factor 7-like 2, Long Noncoding RNA (ANRIL), and CYP2C19*17 Gene Variants and Their Association with Predisposition and Progression in Stroke Patients.Cellular and molecular neurobiology · 2025Article
- Article
- CYP2C19 Polymorphism and Clopidogrel Efficacy in Long-Term Outcomes of Large-Artery Atherosclerotic Stroke: The NCVC Genome Registry.JACC. Asia · 2025Article
- Artificial Intelligence and Multi-Omics in Pharmacogenomics: A New Era of Precision Medicine.Mayo Clinic proceedings. Digital health · 2025Review
- Genetic and clinical determinants of MACE and haemorrhage in antiplatelet therapy: insights from pharmacogenomic analysis.Frontiers in cardiovascular medicine · 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
- CYP2C19 Genotype-Guided Antiplatelet Therapy and Clinical Outcomes in Patients Undergoing a Neurointerventional Procedure.Clinical and translational science · 2025Review
- Development of a Multifaceted Program for Pharmacogenetics Adoption at an Academic Medical Center: Practical Considerations and Lessons Learned.Clinical pharmacology and therapeutics · 2024Article
- Article
- CYP2C19 Genetic Variability, ADP-Induced Whole-Blood Platelet Aggregation, and Clopidogrel Response in an Exploratory Retrospective Cohort of Acute Ischemic Stroke.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The aggregated risk of recurrent stroke in stroke/transient ischemic attack (TIA) patients carrying CYP2C19 LoF alleles who take clopidogrel has not been investigated recently, and the available research is limited. This study aimed to perform an updated meta-analysis to assess the association between CYP2C19 LoF alleles and the risk of recurrent stroke in patients taking clopidogrel. Databases were searched for the literature on eligible studies. The end points were recurrent stroke, composite vascular events, and bleeding events. Odds ratios (ORs) were calculated using RevMan software, where p < 0.05 was considered statistically significant. Patients carrying CYP2C19 LoF alleles who were treated with clopidogrel had a significantly increased risk of recurrent ischemic stroke compared with non-carriers (OR 2.18, 96% CI 1.80-2.63; p < 0.00001). The risk of recurrent stroke was only significantly different in Asian patients (OR 2.29, 96% CI 1.88-2.80; p < 0.00001) but not in patients of other ethnicities; however, there were a limited number of studies in other ethnic groups. Both observational studies (OR 2.83, 96% CI 2.20-3.65; p < 0.00001) and RCTs (OR 1.48, 96% CI 1.10-1.98; p = 0.009) found associations with a significantly increased risk of recurrent ischemic stroke. Asian stroke patients or TIA patients carrying CYP2C19 LoF alleles and taking clopidogrel were at a significantly higher risk of recurrent ischemic stroke than non-carriers. Significantly increased risk of recurrent ischemic stroke was found in both observational studies and RCTs.
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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.