Volume 6, Issue 1, June 2020, Page: 1-6
The Relationship Between Clopidogrel Gene Polymorphism to Progressive Stroke or Recurrence
Yuelian Lian, First Clinical Medicine School, Department of Stomatology, Jinan University, Guangzhou, China
Xiufeng Xin, First Clinical Medicine School, Department of Stomatology, Jinan University, Guangzhou, China; Department of Neurology and Stroke Center, Institute of Clinical Neuroscience, Jinan University, Guangzhou, China
Received: Feb. 15, 2020;       Accepted: Mar. 2, 2020;       Published: Mar. 10, 2020
DOI: 10.11648/j.ijnpt.20200601.11      View  262      Downloads  59
Abstract
Background: Progressive stroke is big problem what's bothering neurophysicians. CYP2C19 gene metabolism test has become more and more popular and even the routine examination of cerebral infarction patients. Objective: To evaluate the correlation of CYP2C19 gene metabolic typing, antiplatelet drug therapy to progressive stroke; to evaluate the relationship between secondary prevention compliance to recurrence of cardiovascular and cerebrovascular events. Method: Through single center and retrospectivly information collected and analyze, collect the information of gene detection of CYP2C19 in patients with acute cerebral infarction admitted within 7 days from 2012 to 2016 and used clopidogrel, antiplatelet drug therapy, past history and others to analyze the related factors to progressive stroke; through regular telephone or outpatient follow-up to evaluate the relationship between secondary prevention compliance to recurrence of cardiovascular and cerebrovascular events. Result: A total of 436 patients were collected. CYP2C19 fast metabolism type (*1/*1) accounted for 39.22%, medium metabolism type (*1/*2 and *1/*3) 50.92%, slow metabolism type 9.86%(*2/*3, *2/*2 and *3/*3). Patients with good secondary prevention compliance had fewer cardiovascular and cerebrovascular recurrence events. There’s no significant correlation between the choice of loading dose of clopidogrel or combination of antiplatelet therapy to progressive stroke and cardiovascular or cerebrovascular events after 3 years of stroke. Conclusion: Limited to retrospective analysis and number of cases in a single center, further research to enlarge the number of centers and cases is needed.
Keywords
Clopidogrel, Progressive Stroke, CYP2C19
To cite this article
Yuelian Lian, Xiufeng Xin, The Relationship Between Clopidogrel Gene Polymorphism to Progressive Stroke or Recurrence, International Journal of Neurologic Physical Therapy. Vol. 6, No. 1, 2020, pp. 1-6. doi: 10.11648/j.ijnpt.20200601.11
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Chinese Medical Association Neurology Society and Chinese Medical Association Neurology Branch of Cerebrovascular Disease. Guidelines for secondary prevention of ischemic stroke and transient ischemic attack in China 2014 [J]. Chinese Journal of Neurology, 2015, 48 (4): 258-273.
[2]
Chinese Medical Association Neurology Society and Chinese Medical Association Neurology Branch of Cerebrovascular Disease. Guidelines for the diagnosis and treatment of Acute Ischemic Stroke in China 2018 [J]. Chinese Journal of Neurology, 2018, 51 (9): 666-682.
[3]
Powers WJ, Rabinstein AA, Ackerson T, et al. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association [J]. Stroke, 2018, 49 (3): e46.
[4]
Pereira NL, Geske JB, Mayr M, et al. Pharmacogenetics of clopidogrel: an unresolved issue [J]. Circ Cardiovasc Gene, 2016, 9 (2): 185-188.
[5]
Sofi F, Marcucci R, Gori AM, et al. Clopidogrel non-responsiveness and risk of cardiovascular morbidity. An updated meta-analysis [J]. Thromb Haemost, 2010, 103 (4): 841-848.
[6]
Lewis JP, Shuldiner AR. Clopidogrel pharmacogenetics: Beyond candidate genes and genome- wide association studies [J]. Clin Pharmacol Ther, 2017, 101 (3): 323-325.
[7]
Amin AM, Sheau Chin L, Azri Mohamed Noor D, et al. The personalization of clopidogrel antiplatelet therapy: the role of integrative pharmacogenetics and pharmacometabolomics [J]. Cardiol Res Pract, 2017, 8062796.
[8]
Gurbel PA, Tantry US. Clopidogrel resistance?[J]. Thromb Res, 2007, 120 (3): 311-321.
[9]
Fiolaki A, Katsanos AH, Kyritsis AP, et al. High on treatment platelet reactivity to aspirin and clopidogrel in ischemic stroke: a systematic review and meta-analysis [J]. J Neurol Sci, 2017, 15 (376): 112-116.
[10]
Chinese Medical Association Neurology Society and Chinese Medical Association Neurology Branch of Cerebrovascular Disease. Guidelines for the diagnosis and treatment of Acute Ischemic Stroke in China 2014 [J]. 2015, (4): 246-257.
[11]
Y Zhao, W Yang, Z Tan, et al. Clopidogrel loading dose versus maintenance dose to treat patients with acute is chaemic stroke in China (CLASS-China): results from a prospective double-blind randomised clinical trial. Stroke Vasc Neurol, 2017, 2 (3): 118-123.
[12]
A Zhang, X Hu, L Yang, et al. Combined analysis of CYP2C19 genotype incidence in Asian healthy population [J], Chinese Journal of evidence based medicine, 2014, 14 (4): 427-34.
[13]
R Han, Y Li. Study on the CYP2C19 gene polymorphism and clinical efficacy of clopidogrel in patients with stroke. Neural Injury and Functional Reconstruction, 2016 (6): 480-482.
[14]
Gilard M, Arnaud B, Cornily JC, et al. Influence of omeprazole on the antiplatelet action of clopidogrel associated with aspirin: the randomized, double-blind OCLA (Omeprazole CLopidogrel Aspirin) study [J]. J Am Coll Cardiol, 2008, 51 (3): 256-260.
[15]
Juurlink DN, Gomes T, Ko DT, et al. A population-based study of the drug interaction between proton pump inhibitors and clopidogrel [J]. CMAJ, 2009, 180 (7): 713-718.
[16]
Y Wang, Y Wang, X Zhao, et al. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N Engl J Med, 2013, 369 (1): 11-9.
Browse journals by subject