College of Pharmacy, Qatar University, Doha, Qatar.
Clin Appl Thromb Hemost. 2019 Jan-Dec;25:1076029619875520. doi: 10.1177/1076029619875520.
Clopidogrel is the cornerstone antiplatelet used in the treatment and prevention of thrombotic events. Some studies examined the effect of polymorphism and nongenetic factors on clopidogrel response in the Middle East and North Africa (MENA) region. However, the consistency among these studies is yet unknown. This study aims to estimate the prevalence of genetic variants in MENA region and to evaluate the effect of these variants as well as the nongenetic factors on clopidogrel responsiveness. A systematic literature search was performed to identify relevant articles. Only observational studies were included. A total of 20 studies in 8 different populations were included. The variant is the most prevalent loss-of-function (LOF) allele in the MENA region (1.7%-35%). The frequency of ranged from 5.3% to 26.9%. Of the 9 studies, 6 found an association between carriers of at least 1 LOF allele and clopidogrel resistance. Older age, high body mass index, females, and the use of calcium channel blockers were associated with clopidogrel resistance as well. Association between the allele and clopidogrel resistance is common among MENA populations. Future studies should focus on having larger sample sizes to detect other minor variant alleles and their effect on bleeding and cardiovascular outcomes.
氯吡格雷是治疗和预防血栓事件中使用的基石抗血小板药物。一些研究考察了中东和北非（MENA）地区遗传变异和非遗传因素对氯吡格雷反应的影响。然而，这些研究之间的一致性尚不清楚。本研究旨在评估 MENA 地区遗传变异的流行率，并评估这些变异以及非遗传因素对氯吡格雷反应性的影响。进行了系统的文献检索以确定相关文章。仅包括观察性研究。共有 8 个不同人群的 20 项研究被纳入。 是 MENA 地区最常见的失活（LOF）等位基因（1.7%-35%）。 的频率范围为 5.3%至 26.9%。在 9 项研究中，有 6 项发现至少携带 1 个 LOF 等位基因的携带者与氯吡格雷抵抗有关。年龄较大、体重指数较高、女性以及使用钙通道阻滞剂也与氯吡格雷抵抗有关。 在 MENA 人群中， 等位基因与氯吡格雷抵抗之间存在关联。未来的研究应侧重于具有更大的样本量，以检测其他次要变异等位基因及其对出血和心血管结局的影响。
