Association of <i>CYP2C19</i> Polymorphisms With Clopidogrel Reactivity and Clinical Outcomes in Chronic Ischemic Stroke
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- Tanaka Tomotaka
- Department of Neurology, National Cerebral and Cardiovascular Center
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- Yamagami Hiroshi
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center Department of Neurology, Kobe City Medical Center General Hospital
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- Ihara Masafumi
- Department of Neurology, National Cerebral and Cardiovascular Center
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- Miyata Toshiyuki
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center
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- Miyata Shigeki
- Department of Clinical Laboratory Medicine, National Cerebral and Cardiovascular Center
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- Hamasaki Toshimitsu
- Department of Data Science, National Cerebral and Cardiovascular Center
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- Amano Shu
- Department of Mathematics and Statistics, Amherst College
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- Fukuma Kazuki
- Department of Neurology, National Cerebral and Cardiovascular Center
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- Yamamoto Haruko
- Center for Advancing Clinical and Translational Sciences, National Cerebral and Cardiovascular Center
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- Nakagawara Jyoji
- Department of Neurosurgery, National Cerebral and Cardiovascular Center
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- Furui Eisuke
- Department of Stroke Neurology, Kohnan Hospital
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- Uchiyama Shinichiro
- Department of Neurology, Tokyo Women’s Medical University International University of Health and Welfare, Sanno Hospital and Sanno Medical Center
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- Hyun Boohan
- Department of Cerebrovascular Disease, NHO Osaka National Hospital
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- Yamamoto Yasumasa
- Department of Neurology, Kyoto Second Red Cross Hospital
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- Manabe Yasuhiro
- Department of Neurology, NHO Okayama Medical Center
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- Ito Yasuhiro
- Department of Neurology, TOYOTA Memorial Hospital
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- Fukunaga Ryuzo
- Department of Cerebrovascular Disease, Hoshigaoka Medical Center
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- Abumiya Takeo
- Department of Neurosurgery, Hokkaido Neurosurgical Memorial Hospital
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- Yasaka Masahiro
- Department of Cerebrovascular Medicine and Neurology, NHO Kyushu Medical Center
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- Kitagawa Kazuo
- Department of Neurology, Tokyo Women’s Medical University Department of Neurology, Osaka University Graduate School of Medicine
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- Toyoda Kazunori
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center
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- Nagatsuka Kazuyuki
- Department of Neurology, National Cerebral and Cardiovascular Center
Bibliographic Information
- Other Title
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- Association of CYP2C19 Polymorphisms With Clopidogrel Reactivity and Clinical Outcomes in Chronic Ischemic Stroke
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Abstract
<p>Background:CYP2C19variants are associated with the antiplatelet effects of clopidogrel against recurrent cardiovascular events. However, it remains unknown whether the elapsed time from stroke onset affects the relationship between the genetic variants and such events. To address this, we conducted a prospective cohort study to determine the effect ofCYP2C19variants on clinical outcomes in the chronic phase.</p><p>Methods and Results:In total, 518 Japanese non-acute stroke patients treated with clopidogrel were registered at 14 institutions. Patients were classified into 3 clopidogrel-metabolizing groups according toCYP2C19genotype: extensive metabolizer (EM:*1/*1), intermediate metabolizer (IM:*1/*2or*1/*3), and poor metabolizer (PM:*2/*2,*2/*3, or*3/*3). Antiplatelet effects of clopidogrel were assessed by adenosine diphosphate (ADP)-induced platelet aggregation and vasodilator-stimulated phosphoprotein (VASP) phosphorylation. The endpoint was composite cerebrocardiovascular events (CVEs). In 501 successfully followed-up patients, the median time from index stroke to enrollment was 181 days. There were 28 cardiovascular and 2 major bleeding events. There were no significant differences in the rates of cardiovascular events among the groups.</p><p>Conclusions:Despite associations betweenCYP2C19variants and on-clopidogrel platelet reactivity, there was no significant difference in rates of CVEs in the chronic stroke phase among the 3 clopidogrel-metabolizing groups ofCYP2C19variants.</p>
Journal
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- Circulation Journal
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Circulation Journal 83 (6), 1385-1393, 2019-05-24
The Japanese Circulation Society
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Details 詳細情報について
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- CRID
- 1390001288139571072
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- NII Article ID
- 130007652780
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- NII Book ID
- AA11591968
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- ISSN
- 13474820
- 13469843
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- NDL BIB ID
- 029688490
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- PubMed
- 31006731
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- Text Lang
- en
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- Data Source
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
- KAKEN
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- Abstract License Flag
- Disallowed