Key result
Clopidogrel in South Asians is not linked to higher recurrent stroke risk versus other ethnicities.
Why the study?
CYP2C19 loss-of-function alleles impair clopidogrel activation and are more common in South Asians, prompting evaluation of ethnic differences in recurrent stroke risk while on clopidogrel.
Does South Asian ethnicity increase the risk of recurrent strokes in patients on clopidogrel compared to other ethnic groups?
Population
1169 patients with ischaemic stroke in a TIA clinic (excluding AF and anticoagulation)
Comparison
South Asian patients vs all other ethnic groups
Design
Retrospective observational study
Authors
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No basis for ethnicity-guided clopidogrel use in secondary stroke prevention; leaves open dedicated trials in South Asian cohorts.
Observational (n=1,034)
Does South Asian ethnicity increase the risk of recurrent strokes in patients on clopidogrel compared to other ethnic groups?
Effect estimate: 22.4% increased relative risk
Absolute Event Rate: 16% vs 13%
p-value: p=0.289
There was a non-significant trend towards a higher incidence of recurrent strokes in South Asian patients on clopidogrel compared to other ethnic groups, suggesting a potential role for targeted CYP2C19 testing.
Musarrat et al. (2026) conducted an observational in Ischemic stroke (n=1,034). Clopidogrel (South Asian ethnicity) vs. Other ethnic groups was evaluated on Recurrent strokes while on clopidogrel (22.4% increased relative risk, p=0.289). South Asian patients on clopidogrel for secondary stroke prevention had a non-significant 22.4% increased relative risk of recurrent stroke compared to other ethnic groups (16% vs 13%; p=0.289).
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