Department of Internal Medicine, King Fahd Hospital of the University, Al-Khobar and College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.
Department of Neurology, King Fahd Hospital of the University, Al-Khobar, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.
Drug Metab Pers Ther. 2021 Jul 8;37(1):35-40. doi: 10.1515/dmpt-2021-0104.
To mitigate the incidence of recurrent stroke in patients, dual antiplatelet therapy comprising aspirin and clopidogrel is usually administered. Clopidogrel is a prodrug and its bioactivation is catalyzed by cytochrome P450 (CYP)2C19. The main objective of this work was to determine the prevalence of carriers in Saudi ischemic stroke patients and assess the suitability of using genotyping to guide antiplatelet therapy in a university hospital setup.
This prospective (2018-2019) study was conducted on 256 patients (age 61 ± 12.5) clinically diagnosed with ischemic stroke who were genotyped using Spartan RX assay.
From the total patient group (256), upon admission, 210 patients were prescribed either aspirin, clopidogrel or dual antiplatelet therapy. Of the 27 patients with the allele who were prescribed clopidogrel (18) or dual antiplatelet therapy (9), only 21 patients could be followed up for a period of six months post stroke event, in addition to 21 age- and sex-matched patients with the normal allele. The allele carriers had a statistically significant increased risk of recurrent stroke compared to patients carrying the normal allele.
This study shows the suitability of using genotyping to guide antiplatelet therapy in ischemic stroke patients in a clinical setting.
为了降低患者中风复发的发生率，通常会采用阿司匹林和氯吡格雷联合的双重抗血小板疗法。氯吡格雷是一种前体药物，其生物活化由细胞色素 P450（CYP）2C19 催化。这项工作的主要目的是确定沙特缺血性中风患者中携带者的流行率，并评估在大学医院环境中使用基因分型来指导抗血小板治疗的适宜性。
这是一项前瞻性（2018-2019 年）研究，对 256 例临床诊断为缺血性中风的患者进行了研究，这些患者使用 Spartan RX 分析进行了基因分型。
在总共 256 例患者中，有 210 例患者在入院时被处方了阿司匹林、氯吡格雷或双重抗血小板治疗。在被处方氯吡格雷（18 例）或双重抗血小板治疗（9 例）的 27 例 等位基因患者中，只有 21 例患者可以在中风事件发生后随访 6 个月，此外，还有 21 例携带正常等位基因且年龄和性别匹配的患者。与携带正常等位基因的患者相比，携带 等位基因的患者中风复发的风险显著增加。
这项研究表明，在临床环境中，使用基因分型来指导缺血性中风患者的抗血小板治疗是适宜的。
