Reply to effect of CYP2C19*2 and *3 on clinical outcome in ischemic stroke patients treated with Clopidogrel

We read with great interest the recent publication of Wang et al. [1] evaluating the relationship between CYP2C19 genotypes with nonfatal ischemic stroke, myocardial infarction, or vascular death. The striking finding of this study was that the presence of CYP2C19 loss of function (LOF) alleles may increase the recurrent risk of ischemic events. The polymorphisms of CYP2C19 may be predictors of poor functional outcome of patients without stent and the effect may be weakened by time [1]. Similarly, the authors recently demonstrated that in patients with transient ischemic attack (TIA) or minor stroke who can be treated within 24h after the onset of symptoms, the combination of Clopidogrel and Aspirin was superior to Aspirin alone for reducing the risk of stroke in the first 90days with no apparent increase in the risk of hemorrhage, only in the subgroup of patients who were not carriers of the CYP2C19 LOF alleles [2].
Source: Journal of the Neurological Sciences - Category: Neurology Authors: Tags: Letter to the Editor Source Type: research