Key result
Among 121 patients with ischemic stroke treated with clopidogrel, hemorrhagic cerebrovascular complications were detected in two patients (1.7%) who were carriers of the CYP2C19*17 polymorphism.
Why the study?
To demonstrate the clinical importance of pharmacogenetic testing for CYP2C19*17 polymorphic carriage in patients with ischemic stroke receiving clopidogrel.
Does the CYP2C19*17 polymorphism increase the risk of hemorrhagic complications in patients with ischemic stroke receiving clopidogrel?
Observational (n=121)
No
Does the CYP2C19*17 polymorphism increase the risk of hemorrhagic complications in patients with ischemic stroke receiving clopidogrel?
Pharmacogenetic testing for the CYP2C19*17 polymorphism in patients with ischemic stroke may help identify individuals at increased risk for hemorrhagic complications when treated with standard doses of clopidogrel.
May support CYP2C19*17 testing to identify clopidogrel responders in stroke; hypothesis-generating and requires prospective validation.
Objective. To demonstrate on a clinical example the importance of conducting pharmacogenetic testing in patients with ischemic stroke receiving clopidogrel in order to identify the polymorphic carriage of CYP2C19*17 (C806T, rs12248560). Materials and methods. A clinical and laboratory examination of 121 patients with ischemic stroke was carried out, the CYP2C19*17 polymorphism (C806T, rs12248560) associated with an increase in the effectiveness of clopidogrel, low residual platelet reactivity, and an increased risk of bleeding was determined. Carriage of polymorphic markers was determined by real-time polymerase chain reaction. Results and conclusion. In two patients (1.7 %), carriers of polymorphic markers CYP2C19*17, hemorrhagic cerebrovascular complications were detected on the background of clopidogrel. Gastrointestinal bleeding, as well as other complications of antiplatelet therapy, are not registered in practice
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Сычев et al. (2023) conducted an observational in Ischemic stroke (n=121). CYP2C19*17 polymorphism vs. Non-carriers was evaluated on Hemorrhagic cerebrovascular complications. Among 121 patients with ischemic stroke treated with clopidogrel, hemorrhagic cerebrovascular complications were detected in two patients (1.7%) who were carriers of the CYP2C19*17 polymorphism.
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