氯吡格雷
医学
阿司匹林
CYP2C19型
冲程(发动机)
缺血性中风
内科学
不利影响
血小板聚集抑制剂
心脏病学
血小板
药物遗传学
基因型
缺血
基因
工程类
化学
细胞色素P450
机械工程
新陈代谢
生物化学
作者
Suli Zhang,Jie Zhu,Hua Li,Fengzhen Li,Bin Zhu,Tao Li,Shuxin Fang,Shengying Qin
出处
期刊:Pharmacogenetics and Genomics
[Ovid Technologies (Wolters Kluwer)]
日期:2021-12-23
卷期号:Publish Ahead of Print
标识
DOI:10.1097/fpc.0000000000000462
摘要
Genetic variation has been considered a major contributor to the high variability in the response to dual antiplatelet therapy in patients with acute ischemic stroke or transient ischemic attack. Recently, incidences of ischemic stroke are increasing rapidly in China. We aimed to evaluate the influence of potential determinants on the response of antiplatelet therapy and adverse events in Chinese ischemic stroke patients receiving clopidogrel-aspirin treatment.Based on the clopidogrel drug response pathway and the coagulation and anticoagulation function, we systematically selected 34 genetic polymorphisms in 12 candidate genes. Three hundred and eight patients were divided into 2 groups according to their degree of inhibition of platelet aggregation. Multivariate analysis was then performed to assess the influence of demographic, clinical and genetic factors on platelet reactivity in Chinese ischemic stroke patients.We found that polymorphisms in CYP2C19 and F2R genes were still significantly associated with platelet reactivity in Chinese ischemic stroke patients (P = 0.037 and 0.015). The newly identified rs168753 in F2R gene may influence the efficacy to clopidogrel-aspirin therapy for ischemic stroke patients. We also found that ischemic stroke patients with low level of inhibition of platelet aggregation had higher risk of recurrent ischemic events (P = 0.001).Together, these results emphasized the necessity of genotype-directed antiplatelet therapy and facilitated to minimize adverse ischemic events.
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