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Efficacy of clopidogrel for stroke depends on CYP2C19 genotype and risk profile

Annals of Neurology Jul 26, 2019

Xu J, et al. - In minor stroke (MS)/transient ischemic attack (TIA) patients stratified by CYP2C19 genotype and risk profiles, researchers conducted this investigation to identify subgroups that DAT could be beneficial for and compared the effectiveness of clopidogrel–aspirin therapy to aspirin therapy. They defined CYP2C19 loss-of-function allele (LoFA) carriers as patients with LoFA of either *2 or *3. There were 1,726 LoFA carriers and 1,068 high-risk patients out of a total of 2,933 MS/TIA patients. There was no significant difference in LoFA carriers for stroke recurrence between clopidogrel–aspirin group and aspirin alone group. Overall, DAT does not benefit LoFA carriers, but there is an important advantage for high-risk LoFA carriers. In Chinese MS/TIA patients, the benefit of clopidogrel depends on CYP2C19 genotype and risk profile.

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