Precision medicine as a predictive factor for risk of hospitalization of recurrent ischemic stroke patients treated with low dose aspirin. A pilot study
ABSTRACTRecurrent ischemic stroke risk after transient ischemic attack was underestimated by most of epidemiological studies due to the widespread use of very different and sometimes restrictive definitions for recurrent stroke instead of a standard definition, making it difficult to assess the bene...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Egyptian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2023.2174833 |
| _version_ | 1811164494299136000 |
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| author | Eman AlHussain A. Gawad Mevidette El Madani Hanan Mostafa Radwa Marwan Abdel halim |
| author_facet | Eman AlHussain A. Gawad Mevidette El Madani Hanan Mostafa Radwa Marwan Abdel halim |
| author_sort | Eman AlHussain A. Gawad |
| collection | DOAJ |
| description | ABSTRACTRecurrent ischemic stroke risk after transient ischemic attack was underestimated by most of epidemiological studies due to the widespread use of very different and sometimes restrictive definitions for recurrent stroke instead of a standard definition, making it difficult to assess the benefit of early prevention of recurrence. Knowing that early intervention by treatment with aspirin reduced fatal recurrent stroke and proved to be cost effective by reducing hospital admission, it was worthwhile studying the pharmacogenetics association as well as biological risk factors of aspirin intolerance for patients with recurrent ischemic stroke. Accordingly, our primary outcome was to investigate the association of CYP2C9*3 (Rs1057910) polymorphism as well as other factors such as diabetes, hypertension and smoking with aspirin intolerance for these patients. The secondary outcome was to study the correlation between TNF-alpha as an inflammatory mediator and the prognosis of ischemic stroke for these patients. Our results showed that although smoking and heterozygous A/C of Rs1057910 still have a higher prevalence however statistically insignificant risk for ischemic stroke recurrence compared with other risk factors; OR1.69 and 1.9, 95%CI (0.471–1.695) and (0.321–11.257) respectively. Also, our results suggest that there is a borderline statistically significant correlation between recurrent stroke prognosis and TNF alpha (p = 0.043). Conclusion: This study failed to detect association of Rs1057910 variant of CYP2C9 gene with preventive aspirin for patients with ischemic stroke. However, a somehow significant association was detected between ischemic stroke prognosis and TNF- α as an inflammatory marker. Further research investigations on larger sample size population are encouraged. |
| first_indexed | 2024-04-10T15:22:13Z |
| format | Article |
| id | doaj.art-075d501f3c8c4fe5800f5aaa8b71df47 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-04-10T15:22:13Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-075d501f3c8c4fe5800f5aaa8b71df472023-02-14T12:48:59ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492023-12-0139115716610.1080/11101849.2023.2174833Precision medicine as a predictive factor for risk of hospitalization of recurrent ischemic stroke patients treated with low dose aspirin. A pilot studyEman AlHussain A. Gawad0Mevidette El Madani1Hanan Mostafa2Radwa Marwan Abdel halim3Chemical Pathology Department, Cairo University, Cairo, EgyptPharmacology Department, National Research Centre, Giza, EgyptDepartment of Anesthesia, surgical intensive care medicine and pain, Cairo University, EgyptChemical Pathology Department, Cairo University, Cairo, EgyptABSTRACTRecurrent ischemic stroke risk after transient ischemic attack was underestimated by most of epidemiological studies due to the widespread use of very different and sometimes restrictive definitions for recurrent stroke instead of a standard definition, making it difficult to assess the benefit of early prevention of recurrence. Knowing that early intervention by treatment with aspirin reduced fatal recurrent stroke and proved to be cost effective by reducing hospital admission, it was worthwhile studying the pharmacogenetics association as well as biological risk factors of aspirin intolerance for patients with recurrent ischemic stroke. Accordingly, our primary outcome was to investigate the association of CYP2C9*3 (Rs1057910) polymorphism as well as other factors such as diabetes, hypertension and smoking with aspirin intolerance for these patients. The secondary outcome was to study the correlation between TNF-alpha as an inflammatory mediator and the prognosis of ischemic stroke for these patients. Our results showed that although smoking and heterozygous A/C of Rs1057910 still have a higher prevalence however statistically insignificant risk for ischemic stroke recurrence compared with other risk factors; OR1.69 and 1.9, 95%CI (0.471–1.695) and (0.321–11.257) respectively. Also, our results suggest that there is a borderline statistically significant correlation between recurrent stroke prognosis and TNF alpha (p = 0.043). Conclusion: This study failed to detect association of Rs1057910 variant of CYP2C9 gene with preventive aspirin for patients with ischemic stroke. However, a somehow significant association was detected between ischemic stroke prognosis and TNF- α as an inflammatory marker. Further research investigations on larger sample size population are encouraged.https://www.tandfonline.com/doi/10.1080/11101849.2023.2174833Recurrenceischemic strokeRs1057910aspirinTNF-alphaCYP2C9 |
| spellingShingle | Eman AlHussain A. Gawad Mevidette El Madani Hanan Mostafa Radwa Marwan Abdel halim Precision medicine as a predictive factor for risk of hospitalization of recurrent ischemic stroke patients treated with low dose aspirin. A pilot study Egyptian Journal of Anaesthesia Recurrence ischemic stroke Rs1057910 aspirin TNF-alpha CYP2C9 |
| title | Precision medicine as a predictive factor for risk of hospitalization of recurrent ischemic stroke patients treated with low dose aspirin. A pilot study |
| title_full | Precision medicine as a predictive factor for risk of hospitalization of recurrent ischemic stroke patients treated with low dose aspirin. A pilot study |
| title_fullStr | Precision medicine as a predictive factor for risk of hospitalization of recurrent ischemic stroke patients treated with low dose aspirin. A pilot study |
| title_full_unstemmed | Precision medicine as a predictive factor for risk of hospitalization of recurrent ischemic stroke patients treated with low dose aspirin. A pilot study |
| title_short | Precision medicine as a predictive factor for risk of hospitalization of recurrent ischemic stroke patients treated with low dose aspirin. A pilot study |
| title_sort | precision medicine as a predictive factor for risk of hospitalization of recurrent ischemic stroke patients treated with low dose aspirin a pilot study |
| topic | Recurrence ischemic stroke Rs1057910 aspirin TNF-alpha CYP2C9 |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2023.2174833 |
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