The good genotype for clopidogrel metabolism is associated with decreased blood viscosity in clopidogrel-treated ischemic stroke patients
Background Blood viscosity (BV) is a measurement of the intrinsic resistance of blood to flow, and high BV increases thromboembolic risk. Although laboratory documentation of clopidogrel resistance has been shown to predict an increased risk of cardiovascular events in patients with ischemic stroke,...
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| Format: | Article |
| Language: | English |
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The Korean Neurocritical Care Society
2020-12-01
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| Series: | Journal of Neurocritical Care |
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| Online Access: | http://e-jnc.org/upload/pdf/jnc-200023.pdf |
| _version_ | 1811219017393766400 |
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| author | Joong Hyun Park Sang Won Han Hyun-Jeung Yu |
| author_facet | Joong Hyun Park Sang Won Han Hyun-Jeung Yu |
| author_sort | Joong Hyun Park |
| collection | DOAJ |
| description | Background Blood viscosity (BV) is a measurement of the intrinsic resistance of blood to flow, and high BV increases thromboembolic risk. Although laboratory documentation of clopidogrel resistance has been shown to predict an increased risk of cardiovascular events in patients with ischemic stroke, there is no evidence that cytochrome P450 2C19 (CYP2C19) polymorphisms in clopidogrel-treated patients influence BV after ischemic stroke. Methods Patients with ischemic stroke or transient ischemic attack within 7 days of symptom onset from April 2018 to October 2019 were included. Patients were classified into the good genotype group for clopidogrel metabolism (ultrarapid or extensive metabolizer) and poor genotype group (intermediate/unknown or poor metabolizer) based on their CYP2C19 genotype status. A scanning capillary-tube viscometer was used to assess whole BV, and patients were divided into decreased BV and increased BV groups. Results The final analyses included 174 patients (109 men and 65 women) with a mean age of 66.4±11.2 years. The good genotype was found in 44% of patients with decreased systolic BV (SBV) and 27% of those with increased SBV (P=0.029), suggesting that BV changes were related to the CYP2C19 genotype for clopidogrel metabolism. Binary logistic regression analysis showed that CYP2C19 genotype status (P=0.024) and baseline SBV (P<0.001) were significantly associated with decreased BV. The good genotype for clopidogrel metabolism was associated with decreased BV in patients with ischemic stroke treated with clopidogrel. Conclusion The present results indicate that the effect of clopidogrel treatment on ischemic stroke prevention could be modulated not only by inhibition of platelet function but also by changes in the hemorheological profile. |
| first_indexed | 2024-04-12T07:18:40Z |
| format | Article |
| id | doaj.art-cf7aa078bd164287bf01025beb4a73cb |
| institution | Directory Open Access Journal |
| issn | 2005-0348 2508-1349 |
| language | English |
| last_indexed | 2024-04-12T07:18:40Z |
| publishDate | 2020-12-01 |
| publisher | The Korean Neurocritical Care Society |
| record_format | Article |
| series | Journal of Neurocritical Care |
| spelling | doaj.art-cf7aa078bd164287bf01025beb4a73cb2022-12-22T03:42:23ZengThe Korean Neurocritical Care SocietyJournal of Neurocritical Care2005-03482508-13492020-12-011329310010.18700/jnc.200023336The good genotype for clopidogrel metabolism is associated with decreased blood viscosity in clopidogrel-treated ischemic stroke patientsJoong Hyun Park0Sang Won Han1Hyun-Jeung Yu2 Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea Department of Neurology, Bundang Jesaeng General Hospital, Seongnam, Republic of KoreaBackground Blood viscosity (BV) is a measurement of the intrinsic resistance of blood to flow, and high BV increases thromboembolic risk. Although laboratory documentation of clopidogrel resistance has been shown to predict an increased risk of cardiovascular events in patients with ischemic stroke, there is no evidence that cytochrome P450 2C19 (CYP2C19) polymorphisms in clopidogrel-treated patients influence BV after ischemic stroke. Methods Patients with ischemic stroke or transient ischemic attack within 7 days of symptom onset from April 2018 to October 2019 were included. Patients were classified into the good genotype group for clopidogrel metabolism (ultrarapid or extensive metabolizer) and poor genotype group (intermediate/unknown or poor metabolizer) based on their CYP2C19 genotype status. A scanning capillary-tube viscometer was used to assess whole BV, and patients were divided into decreased BV and increased BV groups. Results The final analyses included 174 patients (109 men and 65 women) with a mean age of 66.4±11.2 years. The good genotype was found in 44% of patients with decreased systolic BV (SBV) and 27% of those with increased SBV (P=0.029), suggesting that BV changes were related to the CYP2C19 genotype for clopidogrel metabolism. Binary logistic regression analysis showed that CYP2C19 genotype status (P=0.024) and baseline SBV (P<0.001) were significantly associated with decreased BV. The good genotype for clopidogrel metabolism was associated with decreased BV in patients with ischemic stroke treated with clopidogrel. Conclusion The present results indicate that the effect of clopidogrel treatment on ischemic stroke prevention could be modulated not only by inhibition of platelet function but also by changes in the hemorheological profile.http://e-jnc.org/upload/pdf/jnc-200023.pdfblood viscosityhematocritstroke |
| spellingShingle | Joong Hyun Park Sang Won Han Hyun-Jeung Yu The good genotype for clopidogrel metabolism is associated with decreased blood viscosity in clopidogrel-treated ischemic stroke patients Journal of Neurocritical Care blood viscosity hematocrit stroke |
| title | The good genotype for clopidogrel metabolism is associated with decreased blood viscosity in clopidogrel-treated ischemic stroke patients |
| title_full | The good genotype for clopidogrel metabolism is associated with decreased blood viscosity in clopidogrel-treated ischemic stroke patients |
| title_fullStr | The good genotype for clopidogrel metabolism is associated with decreased blood viscosity in clopidogrel-treated ischemic stroke patients |
| title_full_unstemmed | The good genotype for clopidogrel metabolism is associated with decreased blood viscosity in clopidogrel-treated ischemic stroke patients |
| title_short | The good genotype for clopidogrel metabolism is associated with decreased blood viscosity in clopidogrel-treated ischemic stroke patients |
| title_sort | good genotype for clopidogrel metabolism is associated with decreased blood viscosity in clopidogrel treated ischemic stroke patients |
| topic | blood viscosity hematocrit stroke |
| url | http://e-jnc.org/upload/pdf/jnc-200023.pdf |
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