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August 1, 2020BMJ OpenOpen Access

Clopidogrel preventive effect based on cytochrome P450 2C19 genotype in ischaemic stroke: protocol for multicentre observational study

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Key result

New observational protocol evaluates CYP2C19 genotype impact on major CV events in clopidogrel-treated ischemic stroke patients.

Why the study?

Little is known about whether CYP2C19 genotype influences the preventive efficacy of clopidogrel against composite cardiovascular events in patients with stroke.

Does loss-of-function CYP2C19 genotype increase the risk of composite cardiovascular events in acute ischaemic stroke patients treated with clopidogrel compared to extensive metabolisers?

Population

Patients with acute ischaemic stroke receiving clopidogrel within 72 hours of onset and evaluated for CYP2C19 genotype

Comparison

CYP2C19 poor or intermediate metabolisers vs extensive metabolisers

Design

Prospective multicentre observational study protocol

Follow-up

6 months

Authors

TSTae‐Jin SongJKJinkwon KimSHSang Won Han

Discussion

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Member takes

Overview

This protocol describes a prospective observational study to evaluate whether CYP2C19 genotype influences the efficacy of clopidogrel for secondary prevention in patients with acute ischemic stroke.

Study Design

Type

Observational

Multicenter

Yes

Structured PICO

Does loss-of-function CYP2C19 genotype increase the risk of composite cardiovascular events in acute ischaemic stroke patients treated with clopidogrel compared to extensive metabolisers?

P
Population
Patients with acute ischaemic stroke who underwent CYP2C19 genotype evaluation and received clopidogrel within 72 hours of stroke onset, followed for 6 months.
E
Exposure
Clopidogrel in patients with loss-of-function CYP2C19 genotype (poor and intermediate metabolisers)
C
Comparator
Clopidogrel in patients who are non-carriers (extensive metabolisers)
O
Outcome
Composite cardiovascular events (stroke, myocardial infarction, or cardiovascular death) within 6 months after acute ischaemic strokecomposite

This protocol describes a prospective observational study to evaluate whether CYP2C19 genotype influences the efficacy of clopidogrel for secondary prevention in patients with acute ischemic stroke.

Cite This Study

Song et al. (2020) conducted an observational in Acute ischaemic stroke. Loss-of-function CYP2C19 genotype (poor and intermediate metabolisers) vs. Extensive metabolisers (non-carriers) was evaluated on Composite cardiovascular events (stroke, myocardial infarction, or cardiovascular death). This study is a protocol for a prospective observational multicentre study to evaluate the effect of CYP2C19 genotype on cardiovascular events in patients with ischaemic stroke taking clopidogrel.

synapsesocial.com/papers/6aa9332bf89f50ab9e62e27fhttps://doi.org/10.1136/bmjopen-2020-038031
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cytochrome P450 <i>2C19</i> Genotypes and Clopidogrel in Patients With Ischemic Stroke2025 · 9 citations
  2. 2<i>CYP2C19</i> Metabolizer Status and Clopidogrel Efficacy in the Secondary Prevention of Small Subcortical Strokes (SPS3) Study2015 · 55 citations
  3. 3Association with CYP2C19 polymorphisms and Clopidogrel in treatment of elderly stroke patients2021 · 9 citations
  4. 4Impaired clopidogrel activation due to <i>CYP2C19</i> phenoconversion after mild acute ischaemic stroke2026
  5. 5Impact of CYP2C19 Genotype Status on Clinical Outcomes in Patients with Symptomatic Coronary Artery Disease, Stroke, and Peripheral Arterial Disease: A Systematic Review and Meta-Analysis2024 · 18 citations