Clopidogrel Pharmacogenomics and Stroke Prevention

In a Chinese population, loss-of-function genes affecting clopidogrel metabolism negated the benefit of clopidogrel for secondary stroke prevention.

Clopidogrel must be converted to an active metabolite to have its antiplatelet effects, and polymorphisms in the CYP2C19 gene have been linked with varying degrees of clopidogrel responsiveness. To assess whether clopidogrel's effects in stroke prevention vary in patients with and without clopidogrel loss-of-function (LOF) alleles, investigators conducted the CHANCE study. They randomly assigned 5170 Chinese patients with minor stroke or transient ischemic attack within the previous 24 hours to either clopidogrel plus aspirin (C+A) or aspirin alone for a 3-month period. As previously reported, in the overall study population, there was a 32% reduction in stroke with clopidogrel plus aspirin relative to aspirin monotherapy (NEJM JW Neurol Au…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Clopidogrel Pharmacogenomics and Stroke Prevention

Topics

Reviewing Author