Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/23266
Title: Association between CYP2C9 polymorphisms and ischemic stroke following endovascular neurointervention.
Authors: Sreedharan, Subhashaan;Churilov, Leonid;Chan, Jianxiong;Todaro, Marian;Coulthard, Alan;Hocking, Jeffrey;Mahady, Kate;Mitchell, Peter;Dowling, Richard;Bush, Steven;Kwan, Patrick;Yan, Bernard
Affiliation: The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
Department of Radiology, University of Melbourne, Parkville, VIC 3050, Australia
Department of Neurology, Alfred Health, Melbourne, VIC 3004, Australia
Melbourne Brain Centre, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
Department of Medicine, University of Melbourne, Parkville, VIC 3050, Australia
Department of Neuroscience, CCS, Monash University, Melbourne, VIC 3004, Australia
Department of Neurology, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
Department of Medical Imaging, Royal Brisbane and Women's Hospital, QLD 4029, Australia
Academic Discipline of Medical Imaging, University of Queensland, QLD 4072, Australia
Department of Radiology, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
Issue Date: 18-May-2020
EDate: 2020-05-18
Citation: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 2020; online first: 18 May
Abstract: Polymorphisms in the CYP2C9 gene may be associated with adverse vascular events following endovascular procedures independent of antiplatelet therapy. We aimed to investigate the impact of CYP2C9 loss-of-function polymorphisms on adverse vascular events following neurointervention. Consecutive patients undergoing neurointervention were prospectively recruited between 2010 and 2016. Patients were genotyped for the CYP2C9*2 and *3 loss-of-function polymorphisms. On the basis of possible genetic influence on antiplatelet response, ex vivo clopidogrel response was measured using the VerifyNow® P2Y12 Assay. The primary endpoint was the 90-day incidence of adverse vascular events including ischemic stroke. A total of 229 patients were included. The median age was 57 years (IQR: 49-64), and 158 (69.00%) were female. Eighty-one (35.37%) patients carried at least one CYP2C9 loss-of-function (LOF) allele. After adjustment for stroke risk factors, the 90-day incidence of ischemic stroke was significantly lower in the LOF group compared to the wild type group (1.23% vs 10.14%; ORadj = 0.16, 95% CI: 0.03-0.91; p = 0.04). Our results suggest protection against ischemic stroke in carriers of CYP2C9*2 or *3 polymorphisms undergoing neurointervention. Our findings warrant further studies to investigate the mechanisms by which CYP2C9 may influence the risk of ischemic stroke.
URI: http://ahro.austin.org.au/austinjspui/handle/1/23266
DOI: 10.1016/j.jstrokecerebrovasdis.2020.104901
ORCID: 0000-0002-9807-6606
PubMed URL: 32439350
Type: Journal Article
Subjects: Antiplatelet
CYP2C9
Clopidogrel
Endovascular
Ischemia
Neurointervention
Stroke
Appears in Collections:Journal articles

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