Genetic Polymorphisms and Clopidogrel Efficacy for Acute Ischemic Stroke or Transient Ischemic Attack: A Systematic Review and Meta-Analysis
Pooled result · StrokeResult — go to the resultRelative risk 1.92 95% CI 1.57–2.35Authors' conclusion
Carriers of CYP2C19 loss-of-function alleles are at greater risk of stroke and composite vascular events than noncarriers among patients with ischemic stroke or TIA treated with clopidogrel.
Study context
- Population
- Patients with ischemic stroke or transient ischemic attack (TIA) treated with clopidogrel
- Participants
- 4,762 patients · 15 studies
- Comparison
- CYP2C19 loss-of-function allele carriers vs noncarriers
- Outcome
- Stroke, composite vascular events, and any bleeding
Methodological detailsPubMed and EMBASE searched from inception to June 24, 2016
- PubMed and EMBASE searched from inception to June 24, 2016
Pooled result
Stroke
Relative risk
1.92
95% CI 1.57–2.35
P < 0.001
By group
Carriers vs Noncarriers
RR 1.92 (95% CI 1.57–2.35); P < 0.001
As reported in the abstract
Further pooled results
| Outcome | Carriers | Noncarriers | RR (95% CI) | P value | |
|---|---|---|---|---|---|
| Composite vascular eventsStatistical heterogeneity present | 13.7% | 9.4% | 1.51 (1.10–2.06) | P = 0.01 | |
| 0.512Relative risk (log scale) |
Genetic variants other than CYP2C19
- Not associated with clinical outcomes, except significant associations of PON1, P2Y12 and COX-1 with outcomes in 1 study
Safety
| Outcome | Carriers | Noncarriers | RR (95% CI) | P value | |
|---|---|---|---|---|---|
| Any bleeding | 2.4% | 3.1% | 0.89 (0.58–1.35) | P = 0.59 | |
| 0.512Relative risk (log scale) |
Original publication
Genetic Polymorphisms and Clopidogrel Efficacy for Acute Ischemic Stroke or Transient Ischemic Attack: A Systematic Review and Meta-Analysis. Circulation. Published 2 November 2016. doi:10.
Summarised from the published abstract; every number is checked against it