国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Efficacy of Clopidogrel for Stroke Depends on CYP2C19 Genotype and Risk Profile

第一作者：Xu Jie,Wang Anxin,Wangqin Runqi

通讯作者：Wang Yongjun

基本信息

2019-06-25

已发表文章

发表杂志：Annals of neurology

发表类型: Research Article

影响因子(IF): 10.422

PMID: 31237713 Pubmed原文链接 全文下载

主要研究背景及目的

方法

CYP2C19 loss-of-function allele (LoFA) carriers were defined as patients with either LoFA of *2 or *3. Low and high risk profile was defined as Essen stroke risk score (ESRS)<3 and ≥3, respectively. Stroke recurrence at one year was defined as primary outcome.

结论

Overall LoFA carriers do not benefit from DAT, but there is significant benefit for LoFA carriers who are at high risk. The benefit of clopidogrel in Chinese MS/TIA patients depends on CYP2C19 genotype and risk profile.

主要结果

In total 2933 MS/TIA patients, there were 1726 (58.8%) LoFA carriers and 1068 (36.4%) patients at high risk (ESRS≥3). No significant difference for stroke recurrence between clopidogrel-aspirin group and aspirin alone group was found in LoFA carriers (11.2% vs 13.3%, HR, 0.83; 95% CI, 0.64~1.09). In Stratified analyses by CYP2C19 genotype and ESRS, HRs (95% CIs) of the clopidogrel-aspirin therapy for stroke recurrence were 1.00 (0.70~1.42), 0.63 (0.41~0.97), 0.62 (0.40~0.96) and 0.52 (0.31~0.88) among subgroups of LoFA carriers at low risk, LoFA carriers at high risk, LoFA non-carriers at low risk and LoFA non-carriers at high risk, respectively, with p=0.021 for interaction.