Association of genetic variants in CYP2C19 and adverse clinical outcomes after treatment with clopidogrel: An updated meta-analysis

摘要

With dopidogrel treatment after acute coronary syndrome or percutaneous coronary intervention (PCI), or both, the presence of any loss-of-function cytochrome P450 2C19 (CYP2C19) allele (*2, *3, *4, *5, *6, *7, or *8) is associated with reduced concentrations of active drug metabolite and diminished platelet inhibition, whereas the presence of the gain-of-function CYP2C19 allele (*17) is associated with enhanced response to clopidogrel [1]. Yet, consensus is lacking on whether the diminished or enhanced pharmacologic responses translate into worse or better clinical outcomes and whether the proposed increased or reduced risks of major adverse cardiovascular events (MACE) are associated with 2 mutant CYP2C19 alleles or just 1. Therefore, we performed a meta-analysis to address these issues.