Relationship between CYP2C19*2, *3 gene polymorphism and the recurrence in ischemic stroke patients treated with clopidogrel in China: A meta-analysis期刊界 All Journals 搜尽天下杂志传播学术成果专业期刊搜索期刊信息化学术搜索

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*Relationship between CYP2C192, 3 gene polymorphism and the recurrence in ischemic stroke patients treated with clopidogrel in China: A meta-analysis*

Institution:	1. Department of Neurosurgery, Matsuyama Shimin Hospital, Matsuyama City, Ehime, Japan;2. Department of Neurology, Matsuyama Shimin Hospital, Matsuyama City, Ehime, Japan;3. Department of Neurosurgery, Ehime University Graduate School of Medicine, Tōon City, Ehime, Japan;4. Department of Radiology, Matsuyama Shimin Hospital, Matsuyama City, Ehime, Japan;1. Department of Cardiovascular Medicine, Yodogawa Christian Hospital, Osaka, Japan;2. Department of Clinical Laboratory Science, Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, Japan;1. Additional Professor, Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute For Medical Sciences And Technology, Trivandrum, Kerala, India;2. Radiographer, Department of Imaging Sciences and interventional Radiology, Sree Chitra Tirunal Institute For Medical Sciences And Technology, Trivandrum, Kerala, India;3. Senior Project Assistant, Department of Imaging Sciences and interventional Radiology, Sree Chitra Tirunal Institute For Medical Sciences And Technology, Trivandrum, Kerala, India;4. Additional Professor, Neurointervention Center, Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute For Medical Sciences And Technology, Trivandrum, Kerala, India7;5. Professor and Head, Department of Neurology, Sree Chitra Tirunal Institute For Medical Sciences And Technology, Trivandrum, Kerala, India;1. Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China;2. Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA;3. Stroke Medicine, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK;4. Neurology, Foshan Sanshui District People''s Hospital, Foshan, China;5. Neurology, St. Antonius Hospital, Nieuwegein, the Netherlands;6. Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China;7. Stroke Center and Department of Neurology, The First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China;8. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China;9. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China;10. Department of Neurology, Helsinki University Hospital and Helsinki University, Helsinki, Finland;11. Department of Neurology, Basel University Hospital, University of Basel, Switzerland;13. Department of Neurology, Dresden Neurovascular Center, Universitätsklinik Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany;14. Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia;15. Stroke Neurology, National Hospital Organization, Osaka National Hospital, Osaka, Japan;p. Department of Biotechnological and Applied Clinical Sciences, University of L''Aquila, Italy;q. Stroke Outcomes and Decision Neuroscience Research Unit, Division of Neurology, University of Toronto, Toronto, Canada;r. Neurology Service, Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland;s. Department of Neurology, Akershus University Hospital, Lørenskog, Norway;t. International Clinical Research Center and Department of Neurology, St. Anne''s University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic;v. Cooper Neurological Institute, Cooper University Hospital, Camden, NJ, USA;w. Radiology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK;x. Neurology, Leuven University Hospital, Leuven, Belgium;y. Department of Neurology, Linyi People''s Hospital, Linyi, China;z. Department of Emergency, Xiangtan Central Hospital, Xiangtan, China;11. Stroke Center, Bach Mai Hospital, Hanoi Medical University, Hanoi, Vietnam;13. Department of Neurology, General Hospital of Northern Theater Command, Shen Yang, China;14. Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University;15. Neurology, Federal University of Rio Grande do Sul, Porto Alegre; Hospital de Clínicas de Porto Alegre, Brazil;16. Second Department of Neurology “Attikon\" University Hospital, National and Kapodistrian University of Athens, Athens, Greece;17. Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurologie, Hamburg, Germany;18. Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany;19. Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany;110. Neurology, University of Pittsburgh Medical Center, USA;111. Neuroradiologie Interventionelle, Centre Hospitalier de l''Universite de Montreal, Montreal, Canada;1. Department of Endovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan;2. Department of Neurology and Neurological Science, Tokyo Medical and Dental University, Tokyo, Japan;3. Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan;4. Department of Endovascular Surgery, Tokyo Metropolitan Police Hospital, Tokyo, Japan;5. Department of Neurosurgery, Tsuchiura Kyodo General Hospital, Ibaraki, Japan;6. Department of Neurosurgery, Kanto Rosai Hospital, Kanagawa, Japan

Abstract:	BackgroundThe relationship between CYP2C19 2,3 gene variants and the recurrence in ischemic stroke patients treated with clopidogrel is still controversial according to the available published literature. To evaluate correlations between CYP2C19 2,3 gene variants, metabolic typing according to 2, 3 SNPs (the polymorphism of rs4244285, rs4986893) and stroke recurrence, we performed this study through meta-analysis.MethodsLiteratures reporting the relationship between CYP2C192 and 3 polymorphism and the recurrence in ischemic stroke patients treated with clopidogrel were searched in CNKI, Wanfang Database, VIP, China Biomedical Database, PubMed and Cochrane Library from the establishment database to December 2020. Meta-analysis was performed with RevMan 5.3.ResultsA total of 9 articles with 10 trials involving 1333 ischemic stroke patients were included. The results of meta-analysis showed CYP2C192 GA/AA genotype had a higher risk of recurrent stroke than GG in patients with ischemic stroke treated with clopidogrel(P<0.05) (GA+AA vs. GG:OR=2.50, 95% CI:1.66～3.75;GA vs. GG:OR=2.16, 95% CI:1.41～3.31;AA vs. GG:OR=4.40, 95% CI:2.39～8.08; AA vs. GA:OR=2.15, 95% CI:1.20-3.84; allele A vs. G:OR=2.08, 95% CI:1.58-2.75). There was no significant difference in stroke recurrence risk between CYP2C193 GA vs. GG genotype (P=0.65)(OR=0.86,95% CI:0.44～1.67). Compared with extensive metabolizer (EM), patients with intermediate metabolizer (IM) and poor metaholizer (PM) of CYP2C19 had a higher risk of stroke recurrent after clopidogrel treatment (IM+PM vs. EM:OR=2.20, 95%CI:1.58～3.08, P<0.05; IM vs. EM:OR=2.06,95% CI: 1.45～2.91, P<0.05;PM vs. EM: OR=3.32,95% CI:1.98～5.56, P<0.05; PM vs. IM: OR=1.45,95% CI: 0.91～2.32,P=0.11).ConclusionAmong ischemic stroke patients taking clopidogrel, CYP2C192 gene mutation and CYP2C19 metabolizer were associated with stroke recurrence, CYP2C192 and 3 gene carriers were more likely to stroke recurrent than CYP2C191 gene carriers.

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