Association between CYP3A4 gene polymorphisms and clopidogrel response in patients with cardio-cerebrovascular diseases: a systematic review and Meta-analysis

doi:10.5246/jcps.2021.09.064

Abstract

Abstract:

CYP3A4 plays a critical role in clopidogrel activation in the liver. The polymorphism ofCYP3A4 may have an important effect on clopidogrel response in patients with cardio-cerebrovascular diseases. We conducted a systematic review and meta-analysis to evaluate the impact ofCYP3A4 polymorphism on platelet reactivity after clopidogrel treatment and the outcomes of patients. A systematic literature search (up to 7^th October, 2019) was performed on the PubMed, EMBASE, Cochrane Library, clinicaltrials.gov, and Chinese databases, including China National Knowledge Infrastructure (CNKI) and Wan Fang Data. Cohort studies or case-control studies evaluated platelet reactivity and patients’ outcomes in different genotype patients. The Review Manager software was used for data analysis, and the NOS scale was used to assess the quality of included studies. A total of 18 articles were included in the Meta-analysis. The results showed the platelet reactivity after clopidogrel administration had no significant difference betweenCYP3A4 variant carriers and non-carriers. The occurrence of composite ischemic events or stent thrombosis had no significant difference betweenCYP3A4 variant carriers and non-carriers, either. In conclusion, there was no significant association betweenCYP3A4 polymorphism and clopidogrel response in patients with cardio-cerebrovascular diseases.

Key words: Clopidogrel, CYP3A4, Meta-analysis

Supporting:

Sibei Qin, Tong Jia, Yu Fu, Junlei Li, Xinyi Zhang, Chunsu Zhu, Guangkai Liang, Xiaoyan Nie, Luwen Shi, Yimin Cui. Association between CYP3A4 gene polymorphisms and clopidogrel response in patients with cardio-cerebrovascular diseases: a systematic review and Meta-analysis[J]. Journal of Chinese Pharmaceutical Sciences, 2021, 30(9): 762-772.

Figures/Tables 8

Table 1. Characteristics of the 18 studies included in the Meta-analysis.

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