{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:58:39Z","timestamp":1790881119195,"version":"4.1.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose\u2014<\/jats:title>\n                    <jats:p>\n                      Dysglycemia may influence the predictive value of\n                      <jats:italic>CYP2C19<\/jats:italic>\n                      loss-of-function allele for clinical efficacy of antiplatelet drug, but the role of glycated albumin (GA) remains unclear in patients with stroke on antiplatelet drugs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods\u2014<\/jats:title>\n                    <jats:p>\n                      The CHANCE trial (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events) included 2933 patients who had GA levels and\n                      <jats:italic>CYP2C19<\/jats:italic>\n                      genotyping. Cox proportional hazards model was used to assess the interaction between\n                      <jats:italic>CYP2C19<\/jats:italic>\n                      loss-of-function allele (*2, *3) carrier status and the effect of antiplatelet therapy based on their GA levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results\u2014<\/jats:title>\n                    <jats:p>\n                      There was significant interaction between carrier status and antiplatelet therapy regimen on the risk of recurrent stroke (\n                      <jats:italic>P<\/jats:italic>\n                      =0.03) in patients with GA levels of \u226415.5%, but not in those with GA levels of &gt;15.5% (\n                      <jats:italic>P<\/jats:italic>\n                      =0.48). Only in noncarriers with low GA levels, dual-antiplatelet therapy reduced stroke recurrence (3.5%) compared with those on aspirin alone (14.7%; hazard ratio, 0.23; 95% confidence interval, 0.10\u20130.49;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Similar effects were observed when examined the combined vascular event or ischemic stroke. No significant difference in bleeding was found among groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>\n                      In patients with minor stroke or high-risk transient ischemic attack, clopidogrel\u2013aspirin when compared with aspirin alone reduced stroke recurrence only in noncarriers of\n                      <jats:italic>CYP2C19<\/jats:italic>\n                      loss-of-function allele and normal GA levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifier: NCT00979589.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.116.016463","type":"journal-article","created":{"date-parts":[[2017,3,13]],"date-time":"2017-03-13T21:30:21Z","timestamp":1489440621000},"page":"998-1004","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Impact of Glycemic Control on Efficacy of Clopidogrel in Transient Ischemic Attack or Minor Stroke Patients With\n                    <i>CYP2C19<\/i>\n                    Genetic Variants"],"prefix":"10.1161","volume":"48","author":[{"given":"Yi","family":"Lin","sequence":"first","affiliation":[{"name":"From the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China (Y.L., L.O.); China National Clinical Research Center for Neurological Diseases, Beijing, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Center of Stroke, Beijing..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anxin","family":"Wang","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China (Y.L., L.O.); China National Clinical Research Center for Neurological Diseases, Beijing, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Center of Stroke, Beijing..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiejie","family":"Li","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China (Y.L., L.O.); China National Clinical Research Center for Neurological Diseases, Beijing, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Center of Stroke, Beijing..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinxi","family":"Lin","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China (Y.L., L.O.); China National Clinical Research Center for Neurological Diseases, Beijing, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Center of Stroke, Beijing..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Wang","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China (Y.L., L.O.); China National Clinical Research Center for Neurological Diseases, Beijing, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Center of Stroke, Beijing..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Meng","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China (Y.L., L.O.); China National Clinical Research Center for Neurological Diseases, Beijing, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Center of Stroke, Beijing..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lixian","family":"Ou","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China (Y.L., L.O.); China National Clinical Research Center for Neurological Diseases, Beijing, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Center of Stroke, Beijing..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiqi","family":"Chen","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China (Y.L., L.O.); China National Clinical Research Center for Neurological Diseases, Beijing, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Center of Stroke, Beijing..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingquan","family":"Zhao","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China (Y.L., L.O.); China National Clinical Research Center for Neurological Diseases, Beijing, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Center of Stroke, Beijing..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Liu","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China (Y.L., L.O.); China National Clinical Research Center for Neurological Diseases, Beijing, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Center of Stroke, Beijing..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilong","family":"Wang","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (Y.L., A.W., J. Li, J. Lin, X.M., W.C., X.Z., L.L., Yilong Wang, Yongjun Wang); Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China (Y.L., L.O.); China National Clinical Research Center for Neurological Diseases, Beijing, China (Y.L., A.W., J. Li, J. 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