Meta analysis of efficacy and safety of CYP2C19 gene-guided clopidogrel individualized administration for treating ischemic stroke
10.3969/j.issn.1671-8348.2024.09.018
- VernacularTitle:CYP2C19基因指导氯吡格雷个体化治疗缺血性脑卒中有效性和安全性的meta分析
- Author:
Haiyi YANG
1
,
2
,
3
;
Siya LIAN
;
Shihong CAI
;
Leshan HUANG
;
Zhengrong MEI
Author Information
1. 广州医科大学附属第三医院药学部,广州 510150
2. 广东省产科重大疾病重点实验室,广州 510150
3. 广东省妇产疾病临床医学研究中心,广州 510150
- Keywords:
ischemic stroke;
CYP2C19 gene;
clopidogrel;
individual therapy;
meta analysis
- From:
Chongqing Medicine
2024;53(9):1378-1383
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the effectiveness and safety of CYP2C19 genotype test to guide clopi-dogrel individualized therapy in treating ischemic stroke.Methods The databases of PubMed,Embase,Co-chrane Library,Web of Science,Clinical Trail,CBM,CNKI,Wanfang database and VIP database were compre-hensively retrieved.The retrieval time was from the database establishment to August 2023.The randomized controlled trials (RCT) of CYP2C19 gene guiding clopidogrel anti-platelet therapy in the patients with ische-mic stroke were collected.The meta analysis was conducted by adopting the RevMan 5.3 software.Results A total of eleven RCT and 8729 patients with ischemic stroke were included.The meta analysis results showed that there was statistically significant difference in the recurrence rate risk of stroke (OR=0.48,95％CI:0.28-0.83,P=0.008),cardiovascular events incidence rate (OR=0.52,95％CI:0.33-0.82,P=0.005) and incidence rate of all-cause death (OR=0.57,95％CI:0.31-1.06,P=0.070) between clopidogrel individ-ualized anti-platelet treatment based on CYP2C19 genotype detection guidance and conventional anti-platelet treatment.In terms of safety,there were no statistically significant difference in the incidence rate of bleeding between the two groups (OR=1.16,95％CI:0.53-2.50,P=0.710).Conclusion CYP2C19 genotype detec-tion guided clopidogrel personalized anti-platelet therapy could significantly reduce the recurrent rate of stroke and incidence rate of vascular events compared with conventional anti-platelet treatment based on the existing evidence,moreover without increasing the risk of bleeding event occurrence
