Effects of Triflusal and Clopidogrel on the Secondary Prevention of Stroke Based on Cytochrome P450 2C19 Genotyping
| Autor: | Sung Sang Yoon, Sang Won Han, Jun Lee, Kee Ook Lee, Yang-Ha Hwang, Woo-Keun Seo, Seo Hyun Kim, Kyung A. Lee, Yo Han Jung, Jong Yun Lee, Sungwook Yu, Cheryl Bushnell, Yong-Jae Kim, Seong Hwan Ahn, Sung Il Sohn, Hye Yeon Choi, Kyung-Yul Lee, Seung Hun Oh, Hyo Suk Nam, Jun Hong Lee, Youn Nam Kim |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system Neurology Randomization CYP2C19 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine cardiovascular diseases Stroke clopidogrel business.industry Hazard ratio medicine.disease Clopidogrel stroke Confidence interval triflusal lcsh:RC666-701 cytochrome p-450 cyp2c19 Triflusal Original Article Neurology (clinical) Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of Stroke, Vol 19, Iss 3, Pp 356-364 (2017) Journal of Stroke |
| ISSN: | 2287-6405 2287-6391 |
| Popis: | Background and purpose To compare the efficacy and safety of antiplatelet agents for the secondary prevention of ischemic stroke based on cytochrome P450 2C19 (CYP2C19) polymorphisms. Methods This study was a prospective, multicenter, randomized, parallel-group, open-label, blind genotype trial. First time non-cardiogenic ischemic stroke patients were enrolled and screened within 30 days. Participants were randomized to receive either triflusal or clopidogrel for secondary stroke prevention. The primary outcome was the time from randomization to first recurrent ischemic stroke or hemorrhagic stroke. Results The required sample size was 1,080 but only 784 (73%) participants were recruited. In patients with a poor CYP2C19 genotype for clopidogrel metabolism (n=484), the risk of recurrent stroke among those who received triflusal treatment was 2.9% per year, which was not significantly different from those who received clopidogrel treatment (2.2% per year; hazard ratio [HR], 1.23; 95% confidence interval [CI], 0.60-2.53). In the clopidogrel treatment group (n=393), 38% had good genotypes and 62% poor genotypes for clopidogrel metabolism. The risk of recurrent stroke in patients with a good CYP2C19 genotype was 1.6% per year, which was not significantly different from those with a poor genotype (2.2% per year; HR, 0.69; 95% CI, 0.26-1.79). Conclusions Whilst there were no significant differences between the treatment groups in the rates of stroke recurrence, major vascular events, or coronary revascularization, the efficacy of antiplatelet agents for the secondary prevention of stroke according to CYP2C19 genotype status remains unclear. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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