OBJECTIVE Polymorphisms in the CYP2C9 gene may be associated with adverse vascular events following endovascular procedures independent of antiplatelet therapy. We aimed to investigate the impact of CYP2C9 loss-of-function polymorphisms on adverse vascular events following neurointervention. PATIENTS AND METHODS Consecutive patients undergoing neurointervention were prospectively recruited between 2010 and 2016. Patients were genotyped for the CYP2C9*2 and *3 loss-of-function polymorphisms. On the basis of possible genetic influence on antiplatelet response, ex vivo clopidogrel response was measured using the VerifyNow® P2Y12 Assay. The primary endpoint was the 90-day incidence of adverse vascular events including ischemic stroke. RESULTS A total of 229 patients were included. The median age was 57 years (IQR: 49-64), and 158 (69.00%) were female. Eighty-one (35.37%) patients carried at least one CYP2C9 loss-of-function (LOF) allele. After adjustment for stroke risk factors, the 90-day incidence of ischemic stroke was significantly lower in the LOF group compared to the wild type group (1.23% vs 10.14%; ORadj = 0.16, 95% CI: 0.03-0.91; p = 0.04). CONCLUSIONS Our results suggest protection against ischemic stroke in carriers of CYP2C9*2 or *3 polymorphisms undergoing neurointervention. Our findings warrant further studies to investigate the mechanisms by which CYP2C9 may influence the risk of ischemic stroke.

中文翻译：

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CYP2C9基因多态性与血管内神经干预后缺血性卒中的相关性。

CYP2C9基因的多态性可能与血管内手术后独立于抗血小板治疗的不良血管事件有关。我们旨在调查CYP2C9功能丧失多态性对神经干预后不良血管事件的影响。患者与方法前瞻性招募了2010年至2016年间接受神经干预的连续患者。对患者的CYP2C9 * 2和* 3功能丧失多态性进行基因分型。基于对抗血小板反应的可能遗传影响，使用VerifyNow®P2Y12测定法测量了离体氯吡格雷反应。主要终点是包括缺血性中风在内的不良血管事件的90天发生率。结果共纳入229例患者。中位年龄是57岁（IQR：49-64）和158（69。00％）是女性。八十一（35.37％）位患者携带至少一个CYP2C9功能丧失（LOF）等位基因。调整卒中危险因素后，LOF组的90天缺血性卒中发生率显着低于野生型组（1.23％vs 10.14％; ORadj = 0.16，95％CI：0.03-0.91; p = 0.04 ）。结论我们的研究结果表明CYP2C9 * 2或* 3多态性携带者遭​​受神经干预对缺血性中风的保护作用。我们的发现值得进一步研究以研究CYP2C9可能影响缺血性中风风险的机制。ORadj = 0.16，95％CI：0.03-0.91; p = 0.04）。结论我们的研究结果表明CYP2C9 * 2或* 3多态性携带者遭​​受神经干预对缺血性中风的保护作用。我们的发现值得进一步研究，以研究CYP2C9可能影响缺血性中风风险的机制。ORadj = 0.16，95％CI：0.03-0.91; p = 0.04）。结论我们的研究结果表明CYP2C9 * 2或* 3基因多态性携带者遭​​受神经干预对缺血性中风的保护作用。我们的发现值得进一步研究，以研究CYP2C9可能影响缺血性中风风险的机制。