Key result
Genetic polymorphisms lack reported effect sizes for aspirin resistance in patients with cerebral infarction.
Why the study?
Aspirin reduces stroke risk, but some patients develop aspirin resistance, prompting this evaluation of its association with genetic polymorphisms in ischemic stroke.
Are genetic polymorphisms (COX-1, PTGS1, PEAR1, ABCB1, P2RY1) associated with an increased risk of aspirin resistance in Chinese patients with cerebral infarction?
Meta-Analysis
Are genetic polymorphisms (COX-1, PTGS1, PEAR1, ABCB1, P2RY1) associated with an increased risk of aspirin resistance in Chinese patients with cerebral infarction?
Genetic polymorphisms in COX-1, PTGS1, PEAR1, ABCB1, and P2RY1 are strongly associated with the development of aspirin resistance in Chinese patients with ischemic stroke.
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Hypothesis-generating for genetic risk stratification in Chinese stroke patients on aspirin; leaves open whether testing improves outcomes.
Introduction Ischemic stroke, a major subtype of cerebral infarction, results from reduced blood flow to the brain and presents various neurological dysfunctions. Ischemic stroke incidence remains high both globally and in China. Due to its antiplatelet aggregation properties, aspirin is widely used and has been shown to reduce the risk of stroke. However, some patients develop Aspirin Resistance (AR), particularly after recurrent cerebral infarction. This study conducted a systematic review and meta-analysis to examine the association between genetic polymorphism and AR in ischemic stroke. Methods A comprehensive literature search was conducted from October to December 2024 using PubMed, Web of Science, and Embase to identify relevant studies on AR and genetic polymorphisms in Chinese populations. Eight studies, encompassing a total of 2,951 participants and published between 2014 and 2024, met the inclusion criteria. Results The meta-analysis identified five genetic polymorphisms that are significantly correlated with the resistance response of patients with cerebral infarction to aspirin: Cyclooxygenase-1 ( COX-1 ), Prostaglandin-Endoperoxide Synthase 1 ( PTGS1 ), Platelet Endothelial Aggregation Receptor 1 ( PEAR1 ), ATP-Binding Cassette Sub-familyB Member 1 ( ABCB1 ), and P2Y1 Receptor ( P2RY1 ). The overall Odds Ratio (OR) was 11.56 (95% CI: 2.45–54.62), p = 0.002, indicating a strong association between these polymorphisms and AR. OR refer to the allele contrast (dominant vs . wild-type model). Discussion This meta-analysis evaluated the association between genetic polymorphisms and AR in Chinese people, particularly those involving PEAR1, PTGS1, COX-1, ABCB1, and P2Y12 . Conclusion This systematic review and meta-analysis indicate that genetic polymorphisms - especially COX-1, PTGS1, PEAR1, P2Y1, and ABCB1 may play an important role in the development of AR and influence ischemic stroke outcomes in the Chinese population.
Gao et al. (2026) conducted a meta-analysis in Chinese patients with cerebral infarction. Aspirin was evaluated on Association between aspirin resistance and gene polymorphism. This meta-analysis investigated the relationship between aspirin resistance and gene polymorphisms in Chinese patients with cerebral infarction but did not report exact effect sizes or primary outcome statistics.
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