Key result
CYP2C19 loss-of-function carriers on clopidogrel linked to ~29-fold higher recurrent MI risk versus noncarriers.
Why the study?
CYP2C19 loss-of-function alleles reduce clopidogrel efficacy, potentially leading to treatment failure, but their prevalence and association with recurrent cardiovascular events in Thai patients needed evaluation.
Does CYP2C19 loss-of-function carrier status increase the risk of recurrent ischemic stroke or myocardial infarction in patients receiving clopidogrel therapy?
Population
126 patients with CYP2C19 genetic testing results at Bangkok Hospital, Thailand
Comparison
Carriers vs noncarriers of CYP2C19 loss-of-function alleles
Design
Retrospective chart review
Authors
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LOF carriers on clopidogrel may face higher recurrent MI risk; leaves open need for genotype-guided trials in Asian stroke cohorts.
Cohort (n=126)
No
Does CYP2C19 loss-of-function carrier status increase the risk of recurrent ischemic stroke or myocardial infarction in patients receiving clopidogrel therapy?
Effect estimate: OR 29.89 (95% CI 2.29-390.73)
Absolute Event Rate: 19.5% vs 2%
p-value: p=0.01
CYP2C19 loss-of-function alleles are prevalent in the Thai population and are associated with a significantly increased risk of recurrent cardiovascular events in clopidogrel-treated patients, particularly those with a high Essen Stroke Risk Score.
Dumrikarnlert et al. (2025) conducted a cohort in Ischemic stroke or myocardial infarction (n=126). Clopidogrel in CYP2C19 loss-of-function allele carriers vs. Clopidogrel in CYP2C19 noncarriers was evaluated on Recurrent myocardial infarction (OR 29.89, 95% CI 2.29-390.73, p=0.01). CYP2C19 loss-of-function allele carriers treated with clopidogrel had a significantly increased risk of recurrent myocardial infarction (OR 29.89) compared to noncarriers.
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