Evidence map›Paper›PMID 42678292›Full record

ArticleClinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis

CYP2C19 Genetic Variability, ADP-Induced Whole-Blood Platelet Aggregation, and Clopidogrel Response in an Exploratory Retrospective Cohort of Acute Ischemic Stroke.

Soumya Ravichandran, Cattien Phan, Dawn M Meyer, Amirmohammad Eghbalnejadmofrad, Amirhossein Akhavan-Sigari, Seyed Behnam Jazayeri, Sanad Batarseh, Marissa D'Souza, Tiffany Hu, Lovella Hailey and 5 more

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Article in Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

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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

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Soumya RavichandranDepartment of Neurosciences, Comprehensive Stroke Center, University of California San Diego, San Diego, CA, USA.
Cattien PhanDepartment of Neurosciences, Comprehensive Stroke Center, University of California San Diego, San Diego, CA, USA.ORCID 0009-0002-8314-9734
Dawn M MeyerDepartment of Neurosciences, Comprehensive Stroke Center, University of California San Diego, San Diego, CA, USA.
Amirmohammad EghbalnejadmofradDepartment of Neurology, University of Virginia School of Medicine, Charlottesville, VA, USA.
Amirhossein Akhavan-SigariDepartment of Neurological Surgery, Mayo Clinic, Phoenix, AZ, USA.
Seyed Behnam JazayeriDepartment of Neurosciences, Comprehensive Stroke Center, University of California San Diego, San Diego, CA, USA.
Sanad BatarsehDepartment of Neurosciences, Comprehensive Stroke Center, University of California San Diego, San Diego, CA, USA.
Marissa D'SouzaDepartment of Neurosciences, Comprehensive Stroke Center, University of California San Diego, San Diego, CA, USA.
Tiffany HuDepartment of Neurosciences, Comprehensive Stroke Center, University of California San Diego, San Diego, CA, USA.
Lovella HaileyDepartment of Neurosciences, Comprehensive Stroke Center, University of California San Diego, San Diego, CA, USA.
Kunal AgrawalDepartment of Neurosciences, Comprehensive Stroke Center, University of California San Diego, San Diego, CA, USA.
Royya F ModirDepartment of Neurosciences, Comprehensive Stroke Center, University of California San Diego, San Diego, CA, USA.
Thomas HemmenDepartment of Neurosciences, Comprehensive Stroke Center, University of California San Diego, San Diego, CA, USA.
Brett C MeyerDepartment of Neurosciences, Comprehensive Stroke Center, University of California San Diego, San Diego, CA, USA.
Reza Bavarsad ShahripourDepartment of Neurosciences, Comprehensive Stroke Center, University of California San Diego, San Diego, CA, USA.

Funding

San Diego StrokeNet Regional Coordinating CenterU24NS107225 · NINDS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BRETT C MEYER · 2018 to 2026
$2.4M
NINDS NIH HHS U24 NS107225
6 · The paper itself

Abstract

BackgroundPatient response to clopidogrel varies due to CYP2C19 genetic polymorphisms. Impaired metabolism has been linked to an increased risk of recurrent ischemic events. The purpose of this study was to examine CYP2C19 phenotypes and the impact on ADP aggregation in whole blood platelet aggregometry (WBPA) in patients with acute ischemic stroke (AIS).MethodsPatients with AIS or transient ischemic attack (TIA) from two academic comprehensive stroke centers between January 2022 and May 2025 were retrospectively reviewed. Inclusion criteria required both CYP2C19 genotyping and WBPA. Categorical variables were compared using chi-square test and continuous variables using Mann-Whitney U test. Multivariable logistic regression identified independent predictors of inadequate platelet inhibition defined by ADP aggregation threshold.ResultsAmong 112 patients (metabolizers: N=62, non-metabolizers: N=50), there was no correlation between CYP2C19 metabolizer phenotype and ADP-induced platelet aggregation (p=0.49). The study found substantial racial (p=0.012) and Hispanic ethnic (p=0.001) differences in metabolizer phenotype. Inadequate platelet inhibition was also associated with age (p=0.020) loading phase (p=0.04), underscoring the need to consider demographic variables, patient characteristics, and the timing of platelet function testing when interpreting platelet reactivity results and making clinical decisions.ConclusionThis study found no significant association between an individual's CYP2C19 metabolizer status and ADP-induced platelet aggregation. The results of this study may help advance understanding of pharmacogenomics, but care must be taken when interpreting them due to this study's limitations. These findings should be confirmed in a future study.

Indexed as

ClopidogrelCytochrome P-450 CYP2C19Ischemic StrokePlatelet AggregationPlatelet Aggregation InhibitorsAdenosine DiphosphateAgedFemaleGenetic VariationHumansMaleMiddle AgedRetrospective StudiesAdenosine DiphosphateClopidogrelCYP2C19 protein, humanCytochrome P-450 CYP2C19Platelet Aggregation Inhibitorsacute ischemic strokeclopidogrel resistancepersonalized antiplatelet therapypharmacogenomicsplatelet aggregation testing

Identifiers

PMID42678292
PMCPMC13535049

What OpenQuestion holds

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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.