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Drug Res (Stuttg) 2019; 69(01): 23-31
DOI: 10.1055/a-0622-8110
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

P2Y12 Polymorphisms and the Risk of Adverse Clinical Events in Patients Treated with Clopidogrel: A Meta-Analysis

Kun Zhao   *
1   Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
2   Department of Pharmacy, Beijing Friendship Hospital Pinggu Campus, Capital Medical University, Beijing, People's Republic of China
,
Ming Yang   *
3   Department of Anesthesiology, Tianjin Eye Hospital, Tianjin, People's Republic of China
,
Yanxia Lu
4   Department of Pharmacy, The General Hospital of the Chinese People's Armed Police Forces, Beijing, People's Republic of China
,
Shusen Sun
5   College of Pharmacy and Health Sciences, Western New England University, Springfield, Massachusetts, United States of America
,
Wei Li
6   Monogenic Disease Research Center for Neurological Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
,
Xingang Li
1   Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
6   Monogenic Disease Research Center for Neurological Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
,
Zhigang Zhao
1   Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
6   Monogenic Disease Research Center for Neurological Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
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Publikationsverlauf

received 24. Februar 2018

accepted 25. April 2018

Publikationsdatum:
23. Mai 2018 (online)

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Abstract

Background and study aim Some studies have reported an association between P2Y12 gene polymorphisms and clopidogrel adverse outcomes with inconsistent results. We aimed to explore the relationship between P2Y12 polymorphisms and the risk of adverse clinical events in patients treated with clopidogrel through a meta-analysis.

Methods A systematic search of PubMed, Web of Science and the Cochrane Library was conducted. Retrieved articles were comprehensively reviewed and eligible studies were included, and the relevant data was extracted for this meta-analysis. All statistical tests were performed by the Review Manager 5.3 software.

Results A total of 14 studies involving 8,698 patients were included. In the Han Chinese population, ischemic events were associated with P2Y12 T744C polymorphism in the CC vs TT+CT genetic model (OR=3.32, 95%CI=1.62-6.82, P=0.001), and the events were associated with P2Y12 C34T polymorphism in the TT+TC vs CC genetic model (OR=1.70, 95%CI=1.22-2.36, P=0.002). However, ischemic events were not related to P2Y12 G52T polymorphism (TT+TG vs GG: OR=1.13, 95%CI=0.76-1.68, P=0.56; TT vs GG+TG: OR=2.02, 95%CI=0.65-6.28, P=0.22). The associations between the P2Y12 polymorphism and ischemic events were not significant in T744C, G52T and C34T genotype for another subgroup of the Caucasian population (P>0.05). Only two studies referring to bleeding events were included in this analysis of C34T polymorphism, and no significant association was found (TT+TC vs CC: OR=1.07, 95%CI=0.37-3.15, P=0.90).

Conclusions In the Caucasian population, P2Y12 gene polymorphisms are not associated with clinical events. However, in the Chinese Han population, P2Y12 T744C and C34T polymorphisms are significantly associated with adverse clinical events.

Key words

Clopidogrel - adverse clinical events - P2Y12 polymorphism - meta-analysis

* Kun Zhao and Ming Yang contributed equally to this work and should be considered as co-first authors.


Supporting Information

 

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