Association of CYP2C19 gene polymorphisms with long-term recurrent risk of ischemic stroke among ethnic Han Chinese from Fujian.
- Author:
Ling FANG
1
;
Yuting ZHAO
;
Ning WANG
;
Zhenzhen YANG
;
Huiping HUANG
;
Minting LIN
Author Information
- Publication Type:Journal Article
- MeSH: Aged; Alleles; Asian Continental Ancestry Group; genetics; Brain Ischemia; complications; ethnology; China; Cytochrome P-450 CYP2C19; genetics; Female; Gene Frequency; Genetic Predisposition to Disease; ethnology; genetics; Genotype; Humans; Linkage Disequilibrium; Logistic Models; Male; Middle Aged; Platelet Aggregation Inhibitors; therapeutic use; Polymerase Chain Reaction; Polymorphism, Restriction Fragment Length; Polymorphism, Single Nucleotide; Recurrence; Risk Factors; Sequence Analysis, DNA; Stroke; ethnology; etiology; genetics; prevention & control; Ticlopidine; analogs & derivatives; therapeutic use; Time Factors
- From: Chinese Journal of Medical Genetics 2015;32(6):871-876
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo assess the association of genetic polymorphisms of CYP2C19*2,*3,*17 with the recurrence risk of ischemic stroke during clopidogrel prevention in ethnic Han Chinese from Fujian Province.
METHODSClinical data of 985 patients with acute ischemic stroke was collected. After 1 year postdischarge follow-up evaluations, only 114 patients with persistence of clopidogrel were enrolled. CYP2C19 genetic polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)and direct sequencing ,then we analysis the correlation between polymorphisms and the recurrence of stroke.
RESULTSAmong the 114 patients, 23 had a second onset whilst receiving clopidogrel treatment. During the antiplatelet therapy with clopidogrel, carriers of CYP2C19 poor metabolizer (CYP2C19*2/*2 or *2/*3) had a higher rate of recurrent stroke compared with extensive metabolizers (CYP2C19*1/*1) (OR=4.71, 95%CI: 1.18-18.80, P<0.05). Carriers of CYP2C19 *2 mutant allele had increased recurrence compared with those carrying none loss-of-function allele (OR=2.31, 95%CI: 1.20-4.46, P<0.05). The rate of recurrent stroke in those carrying homozygous mutant *2 allele (CYP2C19*2/*2) was 6.14 times greater than the rate of wild-type homozygotes (CYP2C19*1/*1) (95%CI: 1.54-24.54, P<0.05). Patients with previous stroke history had increased risk of recurrence (OR= 4.146, 95%CI: 1.259-13.655, P<0.05). However, CYP2C19*17 was not detected in the group.
CONCLUSIONFor ethnic Han Chinese patients receiving clopidogrel treatment, carriers of poor metabolizer or homozygous mutant *2 allele (CYP2C19*2/*2) have a higher risk of recurrent stroke. The CYP2C19 *2 allele is an independent risk factor for recurrent stroke. Those with previous history of stroke are more prone to the recurrence.
