{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T02:24:51Z","timestamp":1785291891021,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2015,7,15]],"date-time":"2015-07-15T00:00:00Z","timestamp":1436918400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81230027"],"award-info":[{"award-number":["81230027"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Shanghai outstanding academic leaders plan","award":["14XD1403400"],"award-info":[{"award-number":["14XD1403400"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study sought to evaluate the influence of the genetic polymorphisms on platelet reactivity and clinical outcomes in acute ischemic stroke patients taking clopidogrel.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Little research has been published on relationships between genetic polymorphisms, platelet reactivity, and clinical outcomes in stroke patients treated with clopidogrel.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients hospitalized in Changhai Hospital with acute ischemic stroke were randomly enrolled into treatment with a 75\u2010mg daily maintenance dose of clopidogrel. Genotyping was detected by the Mass<jats:styled-content style=\"fixed-case\">ARRAY iPLEX<\/jats:styled-content> genotyping system (Sequenom Inc, San Diego, <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content>), and platelet reactivity was evaluated by the VerifyNow P2Y12 test (Accumetrics Inc., San Diego, <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content>). Sixteen single nucleotide polymorphisms (<jats:styled-content style=\"fixed-case\">SNP<\/jats:styled-content>s) within 9 genes were selected and high on\u2010clopidogrel platelet reactivity (<jats:styled-content style=\"fixed-case\">HPR<\/jats:styled-content>) was defined as P2Y12 reaction units (<jats:styled-content style=\"fixed-case\">PRU<\/jats:styled-content>) value \u2265230. The primary endpoint was ischemic events, including major adverse cardiac events (<jats:styled-content style=\"fixed-case\">MACE<\/jats:styled-content>), recurrence of stroke, transient ischemic attack (<jats:styled-content style=\"fixed-case\">TIA<\/jats:styled-content>), and the composite of vascular death, and the secondary endpoint was bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 345 patients recruited, 275 (79.7%) patients were followed up for 1\u00a0year and 122 (35.4%) patients were categorized as <jats:styled-content style=\"fixed-case\">HPR<\/jats:styled-content>. Among the <jats:styled-content style=\"fixed-case\">SNP<\/jats:styled-content>s selected, only the <jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>2C19*2 allele and the <jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>2C19*3 allele were statistically significantly associated with <jats:styled-content style=\"fixed-case\">PRU<\/jats:styled-content> (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001 and <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.003, respectively). Similarly, the prevalence of <jats:styled-content style=\"fixed-case\">HPR<\/jats:styled-content> was associated with <jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>2C19*2 and <jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>2C19*3 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001 and <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001, respectively). During the 1\u00a0year of follow\u2010up, a total of 64 (23.3%) cases of clinical events occurred, including 60 ischemic events and 4 bleeding events. There were no correlation between <jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>2C19 variant alleles and clinical outcomes (<jats:italic>P\u00a0<\/jats:italic>&gt;<jats:italic>\u00a0<\/jats:italic>0.05), but a statistically significant relevance was found between the <jats:styled-content style=\"fixed-case\">HPR<\/jats:styled-content> and the ischemic events in 1\u00a0year of follow\u2010up (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>2C19*2 and <jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>2C19*3 had a significant impact on clopidogrel response, but was not associated with ischemic events during 1\u00a0year of follow\u2010up in patients with acute ischemic stroke. <jats:styled-content style=\"fixed-case\">HPR<\/jats:styled-content> was an independent risk factor for ischemic events, and the VerifyNow P2Y12 test may be available to guide individualized antiplatelet therapies in stroke patients in China.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cns.12426","type":"journal-article","created":{"date-parts":[[2015,7,15]],"date-time":"2015-07-15T06:17:51Z","timestamp":1436941071000},"page":"692-697","source":"Crossref","is-referenced-by-count":43,"title":["Influence of Genetic Polymorphisms on Clopidogrel Response and Clinical Outcomes in Patients with Acute Ischemic Stroke CYP2C19 Genotype on Clopidogrel Response"],"prefix":"10.1111","volume":"21","author":[{"given":"Yan","family":"Han","sequence":"first","affiliation":[{"name":"Department of Neurology Changhai Hospital Second Military Medical University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui\u2010Hui","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Neurology Changhai Hospital Second Military Medical University Shanghai 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