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首页> 外文期刊>Stroke: A Journal of Cerebral Circulation >Efficacy of Clopidogrel-Aspirin Therapy for Stroke Does Not Exist in CYP2C19 Loss-of-Function Allele Noncarriers With Overweight/Obesity
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Efficacy of Clopidogrel-Aspirin Therapy for Stroke Does Not Exist in CYP2C19 Loss-of-Function Allele Noncarriers With Overweight/Obesity

机译：CYP2C19中氯吡格雷林疗法治疗中风的疗效不存在于具有超重/肥胖的功能性等位基因非载体

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摘要

Background and Purpose- The role of dual-antiplatelet therapy with clopidogrel plus aspirin has been demonstrated to substantially decrease the risk of recurrent stroke among patients with minor stroke and transient ischemic attack. We aimed to determine whether the efficacy of clopidogrel-aspirin therapy among patients with minor stroke / transient ischemic attack was influenced by the stratification of CYP2C19 genotype and body mass index (BMI). Methods- CYP2C19 loss-of-function allele (LoFA) carriers were defined as patients with either LoFA of *2 or *3. Low/normal weight and overweight/obesity was defined as BMI = 25 kg/m(2), respectively. Primary outcome was defined as stroke recurrence at 3 months. Results- In a total of 2933 patients, there were 1726 (58.8%) LoFA carriers and 1275 (43.5%) patients with overweight/obesity (BMI >= 25 kg/m(2)). Stratified analyses by LoFA carrying status and BMI, hazard ratios (hazard ratios 95% CIs) of the clopidogrel-aspirin therapy for stroke recurrence were 0.90 (0.60-1.36), 0.87 (0.56-1.35), 0.65 (0.39-1.09), and 0.40 (0.22-0.71) among subgroups of LoFA carriers with overweight/obesity, LoFA carriers with low/normal weight, LoFA noncarriers with overweight/obesity, and LoFA noncarriers with low/normal weight, respectively, with P=0.049 for interaction. Conclusions- Efficacy of clopidogrel-aspirin therapy in reducing the risk of stroke recurrence is not present in CYP2C19 LoFA noncarriers with overweight/obesity. Our study suggests that BMI significantly influences the correlation between CYP2C19 genotype and efficacy of clopidogrel-aspirin therapy.
机译：背景论和目的 - 双抗血小板治疗与氯吡格雷加阿司匹林的作用已经证明，显着降低了轻微中风和短暂性缺血症患者复发性中风的风险。我们旨在确定氯吡格雷林素治疗是否患有轻微中风/瞬态缺血症患者的疗效是受CYP2C19基因型和体重指数（BMI）的分层的影响。方法 - CYP2C19函数损失等位基因（LOFA）载体被定义为* 2或* 3的患者。低/正常重量和超重/肥胖分别定义为BMI = 25kg / m（2）。主要结果在3个月内定义为卒中复发。结果 - 总共2933名患者，有1726名（58.8％）的洛菲载体和1275名（43.5％）超重/肥胖患者（BMI> = 25kg / m（2））。通过Lofa携带状态和BMI，氯吡格雷林氏素治疗的危险比（危险比率95％CIS）进行分层分析，用于中风复发为0.90（0.60-1.36），0.87（0.56-1.35），0.65（0.39-1.09），和0.40（0.22-0.71）在洛杉矶载体的亚组中，具有超重/肥胖，洛杉矶载体具有低/正常重量的洛菲载流子，具有超重/肥胖的洛杉矶非载体，以及分别具有低/正常重量的LOFA非载体，用于相互作用的低/ 0.049。结论 - 氯吡格雷林治疗降低卒中复发风险的疗效不存在于具有超重/肥胖的Cyp2C19洛伐比子载体中。我们的研究表明，BMI显着影响CYP2C19基因型与氯吡格雷林疗法的相关性之间的相关性。

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    Mo Jinglin; Chen Zimo; Xu Jie; Wang Anxin; Dai Liye; Cheng Aichun; Meng Xia; Li Hao; Wang Yongjun; Johnston S. Claiborne; Wang Yilong; Zhao Xingquan; Wang Zhimin; Xia Haiqin; Li Bin; Zhang Guiru; Ren Xudong; Ji Chunling; Zhang Guohua; Li Jianhua; Lu Bohua; Wang Liping; Feng Shutao; Wang Dali; Tang Weiguo; Li Juntao; Zhang Hongtian; Li Guanglai; Wang Baojun; Chen Yuhua; Lian Ying; Liu Bin; Teng Junfang; Sui Rubo; Li Lejun; Yuan Zhiling; Zang Dawei; Lu Zuneng; Sun Li; Wang Dong; Hou Liying; Yuan Dongcai; Cao Yongliang; Li Hui; Tan Xiuge; Wang Huicong; Du Haisong; Liu Mingyi; Wang Suping; Liu Qiuwu; Zhang Zhong; Cui Qifu; Wang Runqing; Zhao Jialin; Zhang Jiewen; Zhao Jianping; Bi Qi; Qi Xiyou; Liu Junyan; Li Changxin; Li Ling; Pan Xiaoping; Zhang Junling; Jiao Derang; Han Zhao; Qian Dawei; Xiao Jin; Xing Yan; Du Huishan; Huang Guang; Cui Yongqiang; Li Yan; Feng Lianyuan; Gao Lianbo; Xiao Bo; Cao Yibin; Wu Yiping; Liu Jinfeng; Zhang Zhiming; Dong Zhengxie; Wang Limin; He Li; Wang Xinchen; Guo Xueying; Wang Ming; Wang Xiaosha; Jiang Jiandong; Zhao Renliang; Zhou Shengnian; Hu Hao; He Maolin; Yu Fengchun; Ouyang Quping; Zhang Jingbo; Xu Anding; Qi Xiaokun; Wang Lei; Shi Fuming; Guo Fuqiang; Wang Jianfeng; Zhao Fengli; Dou Ronghua; Wei Dongning; Meng Qingwei; Xia Yilu; Wang Shimin; Xue Zhangcang; Xu Yuming; Ma Liping; Wang Chun; Wu Jiang; Du Yifeng; Wang Yinzhou; Xiao Lijun; Song Fucong; Hu Wenli; Chen Zhigang; Liu Qingrui; Zhang Jiemin; Chen Mei; Yuan Xiaodong; Liu Zhihui; Li Guozhong; Li Xiaohong; Tian Tingchen;

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    Capital Med Univ Beijing Tiantan Hosp Dept Neurol Beijing Peoples R China;

    Capital Med Univ Beijing Tiantan Hosp Dept Neurol Beijing Peoples R China;

    Capital Med Univ Beijing Tiantan Hosp Dept Neurol Beijing Peoples R China;

    Capital Med Univ Beijing Tiantan Hosp Dept Neurol Beijing Peoples R China;

    Capital Med Univ Beijing Tiantan Hosp Dept Neurol Beijing Peoples R China;

    Capital Med Univ Beijing Tiantan Hosp Dept Neurol Beijing Peoples R China;

    Capital Med Univ Beijing Tiantan Hosp Dept Neurol Beijing Peoples R China;

    Capital Med Univ Beijing Tiantan Hosp Dept Neurol Beijing Peoples R China;

    Capital Med Univ Beijing Tiantan Hosp Dept Neurol Beijing Peoples R China;

    Univ Texas Austin Med Sch Austin TX 78712 USA;

    Beijing Tiantan Hosp Beijing Peoples R China;

    Beijing Tiantan Hosp Beijing Peoples R China;

    Taizhou First Peoples Hosp Taizhou Peoples R China;

    Taiyuan Iron &

    Steel Grp Co Ltd Gen Hosp Taiyuan Shanxi Peoples R China;

    Dagang Oilfield Gengeal Hosp Dagang Peoples R China;

    Penglai Peoples Hosp Yantai Peoples R China;

    Third Peoples Hosp Datong Datong Peoples R China;

    Fourth Cent Hosp Tianjin Tianjin Peoples R China;

    Hebei Med Univ Hosp 2 Wuhan Hubei Peoples R China;

    First Hosp Fangshan Dist Beijing Peoples R China;

    Beijing Puren Hosp Beijing Peoples R China;

    Tianjin Ninghe Dist Hosp Tianjin Peoples R China;

    Peoples Hosp Zhengzhou Zhengzhou Henan Peoples R China;

    North China Coal Med Coll Affiliated Hosp Hengshui Peoples R China;

    Zhejiang Zhoushan Hosp Zhoushan Peoples R China;

    Han Dan Cent Hosp Handan Peoples R China;

    Zhecheng Peoples Hosp Shangqiu Peoples R China;

    Shanxi Med Univ Hosp 2 Taiyuan Shanxi Peoples R China;

    Baotou Cent Hosp Baotou Peoples R China;

    Gen Hosp Changjiang River Shipping Wuhan Hubei Peoples R China;

    Dalian Econ &

    Technol Dev Zone Hosp Dalian Peoples R China;

    North China Coal Med Coll Affiliated Hosp Hengshui Peoples R China;

    Zhengzhou Univ Affiliated Hosp 1 Zhengzhou Henan Peoples R China;

    Liaoning Med Affiliated Hosp Dalian Peoples R China;

    Lianyungang Municipal Hosp TCM Nanjing Jiangsu Peoples R China;

    Cent Hosp Qiu Cty Bade Peoples R China;

    Tianjin First Ctr Hosp Tianjin Peoples R China;

    Wuhan Univ Renmin Hosp Wuhan Hubei Peoples R China;

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    Changzhi City Peoples Hosp Shanxi Prov Taiyuan Shanxi Peoples R China;

    HaLixun Int Peace Hosp Taocheng Peoples R China;

    Peoples Hosp Linzi Dist Zibo Peoples R China;

    Yantai City Yantai Mt Hosp Yantai Peoples R China;

    Beijing Pinggu Dist Hosp Beijing Peoples R China;

    Taiyuan Cent Hosp Taiyuan Shanxi Peoples R China;

    Chengde Cent Hosp Chengde Peoples R China;

    Shijiazhuang Cent Hosp Shijiazhuang Hebei Peoples R China;

    Dalian Municipal Cent Hosp Dalian Peoples R China;

    Xian 141 Hosp Xian Shaanxi Peoples R China;

    Chengdu Third Municipal Peoples Hosp Chengdu Sichuan Peoples R China;

    Chifeng Univ Affiliated Hosp Chifeng Peoples R China;

    Zhengzhou Cent Hosp Zhengzhou Henan Peoples R China;

    Zhejiang Prov Lihuili Hosp Med Ctr Ningbo Zhejiang Peoples R China;

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    Hebei Med Univ Hosp 3 Shijiazhuang Hebei Peoples R China;

    Shanxi Med Univ Affiliated Hosp 1 Taiyuan Shanxi Peoples R China;

    Hebei Prov Peoples Hosp Wuhan Hubei Peoples R China;

    Guangzhou First Municipal Peoples Hosp Guangzhou Guangdong Peoples R China;

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    Luhe Hosp Beijing Peoples R China;

    Capital Med Univ Beijing Fuxing Hosp Beijing Peoples R China;

    306th Hosp PLA Beijing Peoples R China;

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    Baiqiuen Int Peace Hosp Peoples Liberat Army Yantai Peoples R China;

    China Med Univ Affiliated Hosp 4 Beijing Peoples R China;

    Cent S Univ Xiangya Hosp Changsha Hunan Peoples R China;

    Tangshan Workers Hosp Tangshan Peoples R China;

    1st Hosp Handan Handan Peoples R China;

    Yangquan Coal Grp Co Ltd Gen Hosp Yangquan Peoples R China;

    Tianjin Tianhe Hosp Tianjin Peoples R China;

    Nantong First Peoples Hosp Nantong Peoples R China;

    First Hosp Zhangjiakou City Zhangjiakou Peoples R China;

    Sichuan Univ West China Hosp Chengdu Sichuan Peoples R China;

    Shandong Univ TCM Affiliated Hosp 2 Jinan Shandong Peoples R China;

    Fenyang Hosp Shanxi Prov Lvliang Peoples R China;

    Zhejiang Zhoushan Putuo Dist Peoples Hosp Zhoushan Peoples R China;

    China Acad Chinese Tradit Med Xiyuan Hosp Hefei Anhui Peoples R China;

    2 Peoples Hosp East Lianyungang City Lianyungang Peoples R China;

    Qingdao Univ Affiliated Hosp Med Coll Qingdao Shandong Peoples R China;

    Shandong Univ Qilu Hosp Jinan Shandong Peoples R China;

    Zibo Hosp Tradit Chinese Med Jinan Shandong Peoples R China;

    Beijing Shijitan Hosp Beijing Peoples R China;

    Beijing Haidian Hosp Beijing Peoples R China;

    Beijing Shunyi Dist Hosp Beijing Peoples R China;

    Dalian Third Municipal Hosp Dalian Peoples R China;

    Jinan Univ Affiliated Hosp 1 Jinan Shandong Peoples R China;

    Navy Gen Hosp PLA Beijing Peoples R China;

    Beijing Second Artillery Gen Hosp Beijing Peoples R China;

    Beijing Daxing Dist Hosp Beijing Peoples R China;

    Sichuan Prov Peoples Hosp Chengdu Sichuan Peoples R China;

    Dalian Municipal Cent Hosp Dalian Peoples R China;

    Second Hosp Baoding Baoding Peoples R China;

    Hosp Combine Tradit Chinese &

    Western Med Cang Zh Cangzhou Peoples R China;

    309th Hosp PLA Beijing Peoples R China;

    Liangxiang Hosp Fangshan Dist Beijing Peoples R China;

    Tsinghua Univ HuaXin Hosp Hosp 1 Beijing Peoples R China;

    Tianjin Huanhu Hosp Tianjin Peoples R China;

    Shijiazhuang First Hosp Shijiazhuang Peoples R China;

    Zhengzhou Univ Affiliated Hosp 1 Zhengzhou Henan Peoples R China;

    Xinzhou City Peoples Hosp Xinzhou Peoples R China;

    Sichuan Prov Peoples Hosp Deyang City Deyang Peoples R China;

    Jilin Univ Hosp 1 Changchun Jilin Peoples R China;

    Shandong Prov Hosp Jinan Shandong Peoples R China;

    Fujian Prov Hosp Fuzhou Fujian Peoples R China;

    Liaoyang City Third Peoples Hosp Liaoyang Peoples R China;

    Handan City Ctr Hosp Handan Peoples R China;

    Capital Med Univ Beijing Chaoyang Hosp Beijing Peoples R China;

    Beijing Univ Chinese Med East Hosp Beijing Peoples R China;

    Hebei Med Univ Hosp 4 Shijiazhuang Hebei Peoples R China;

    Soochow Univ Affiliated Hosp 4 Suzhou Peoples R China;

    Zhejiang Univ Chinese Med Affiliated Hosp 1 Hangzhou Zhejiang Peoples R China;

    Kailuan Co Ltd Affiliated Hosp Tangshan Peoples R China;

    Weifang Med Univ Affiliated Hosp Weifang Peoples R China;

    Harbin Med Univ Hosp 1 Harbin Heilongjiang Peoples R China;

    Dalian Friendship Hosp Dalian Peoples R China;

    Tianjin Dagang Hosp Tianjin Peoples R China;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 神经病学与精神病学;
  • 关键词

    allele; aspirin; body mass index; clopidogrel; overweight;

    机译：等位基因;阿司匹林;体重指数;氯吡格雷;超重;

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