Impact of Cytochrome P450 2C19 Polymorphism on Ischemic Stroke Prognosis

Abstract Background Stroke is the leading cause of mortality and impairment in China. Genetic variations in cytochrome P450 2C19 (CYP2C19) have been associated with the occurrence and outcomes of ischemic stroke (IS). We aimed to explore the correlation between CYP2C19 polymorphism and IS morbidity and prognosis. Methods We retrospectively enrolled 157 patients with IS who were admitted to the Affiliated Panyu Centra Hospital of Guangzhou Medical University between April 2021 and March 2022 and underwent long-term antiplatelet therapy. A total of 142 inpatients without IS or coronary heart disease were enrolled as controls. Telephone follow-ups were conducted for the IS group, and the modified Rankin Scale was used to assess prognosis. We explored the association between CYP2C19 genotype and IS by using multivariate logistic regression to analyze variables influencing disease occurrence and prognosis. Results Significant differences were identified in the occurrence rates of CYP2C19*2 GG/GA and *3 GG/GA genotypes between the IS (P = 0.014, 0.006, respectively) and control groups (P = 0.006, 0.009, respectively). A notable disparity was observed in the allelic frequency of CYP2C19*3 G(A) (P = 0.005). IS morbidity was considerably greater in the intermediate metabolizer (IM) group than in the extensive metabolizer group (P < 0.001). Hyperlipidemia, diabetes, hypertension, and CYP2C19 IM were independent risk factors of IS (P < 0.001). No variation was observed in the CYP2C19 genotype between the good and poor prognosis groups (P = 0.893). Conclusion CYP2C19 polymorphism was related to IS morbidity but had no significant correlation with prognosis.