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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >CYP2C19 Genotype and Early Ischemic Lesion Recurrence in Stroke Patients Treated with Clopidogrel
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CYP2C19 Genotype and Early Ischemic Lesion Recurrence in Stroke Patients Treated with Clopidogrel

机译：氯吡格雷治疗中风患者CYP2C19基因型与早期缺血性病变的复发

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Background: Early recurrent ischemic lesions detected on diffusion-weighted imaging (DWI) have been proposed as a surrogate marker for clinical recurrence. We hypothesized that cytochrome P450 2C19 (CYP2C19) genotype influences the incidence of early recurrence on DWI in acute stroke patients treated with clopidogrel. Methods: We enrolled 76 Korean patients with acute ischemic stroke due to large artery atherosclerosis who were treated with clopidogrel. Early ischemic lesion recurrence was defined as new lesions separate from the index lesion. We compared the rates of early ischemic lesion recurrence on DWI based on the CYP2C19 genotypes. Results: Early recurrence on DWI was observed in 36 patients (47.4%). A total of 76 patients were classified into 3 phenotypic groups: extensive metabolizers (EMs; n = 27, 35.5%), intermediate metabolizers (IMs; n = 36, 47.4%), and poor metabolizers (PMs; n = 13, 17.1%). Early recurrence on DWI was more common in PMs (84.6%), followed by IMs (50.0%), and EMs (25.9%; P < .001). PMs had a significantly higher recurrence rate than EMs (P < .001). In multivariate analysis, CYP2C19 genotypes were independently associated with early DWI recurrence (for PMs: odds ratio, 19.3; 95% confidence interval, 3.15-117.56). Conclusions: CYP2C19 genotypes are significantly associated with early lesion recurrence in Korean acute stroke patients treated with clopidogrel.
机译：背景：在弥散加权成像（DWI）上发现的早期复发性缺血性病变已被提议作为临床复发的替代指标。我们假设细胞色素P450 2C19（CYP2C19）基因型影响氯吡格雷治疗的急性卒中患者DWI早期复发的发生率。方法：我们纳入了76例接受氯吡格雷治疗的大动脉粥样硬化引起的急性缺血性卒中的韩国患者。早期缺血性病变复发的定义是新病变与指数病变分开。我们根据CYP2C19基因型比较了DWI上早期缺血性病变的复发率。结果：DWI早期复发36例（47.4％）。总共76位患者被分为3个表型组：广泛代谢者（EMs; n = 27，35.5％），中度代谢者（IMs; n = 36，47.4％）和不良代谢者（PMs; n = 13，17.1％ ）。 DWI的早期复发较常见于PM（84.6％），其次是IM（50.0％）和EM（25.9％; P <.001）。 PMs的复发率明显高于EMs（P <.001）。在多变量分析中，CYP2C19基因型与DWI早期复发独立相关（对于PM：优势比为19.3; 95％置信区间为3.15-117.56）。结论：在接受氯吡格雷治疗的韩国急性卒中患者中，CYP2C19基因型与早期病灶复发显着相关。

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