ABCB1 C3435T polymorphism and risk of adverse clinical events in clopidogrel treated patients: A meta-analysis
ABCB1 C3435T polymorphism and risk of adverse clinical events in clopidogrel treated patients: A meta-analysis
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ABCB1 C3435T 多态性和氯吡格雷治疗患者不良临床事件的风险：荟萃分析
DOI：
10.1016/j.thromres.2011.12.003
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发表时间：
2012-06-01
影响因子：
7.5
通讯作者：
Sheng, Wenli
中科院分区：
文献类型：
--
作者：
Luo, Man;Li, Jiaoxing;Sheng, Wenli
简介：ABCB 1 C3435 T多态性限制了氯吡格雷的口服生物利用度，并可能影响接受氯吡格雷治疗的患者的预后。有几项研究检测了C3435 T多态性与氯吡格雷治疗患者不良临床事件风险之间的关系，但结果不一致。为了评估C3435 T多态性对临床结局的影响，进行了一项荟萃分析。方法：6项研究，10,153例受试者纳入本荟萃分析。根据异质性选择固定效应模型或随机效应模型。结果：C3435 T基因多态性与氯吡格雷治疗患者缺血性事件总复发风险的相关性在所有遗传模型中均无统计学意义（OR=1.13，95%CI：0.78-1.64，P=0.51; OR=1.15，95%CI：0.99-1.33，P=0.07; OR=1.19，95%CI：0.81-1.76，P=0.37）。C3435 T多态性与短期复发性缺血事件的风险显著相关（OR=1.55，95%CI：1.09-2.20，P=0.01; OR=1.41，95%CI：1.06-1.87，P=0.02; OR=1.77，95%CI：1.19-2.63，P=0.005）。C3435 T多态性与支架内血栓形成之间无统计学显著相关性（OR=0.79，95% CI：0.47-1.32，P=0.37）或出血（OR=0.98，95%CI：0.79-1.21，P=0.82），结果可能受到发表偏倚的影响。该荟萃分析未能显示ABCB 1 C3435 T多态性与氯吡格雷治疗患者的总体复发性缺血事件、支架血栓形成或出血风险之间的相关性。然而，C3435 T多态性的TT纯合子与短期复发性缺血事件的风险之间可能存在关联，但需要更多的研究来证实。(C)2011爱思唯尔有限公司版权所有。
Introduction: The ABCB1 C3435T polymorphism limits oral bioavailability of clopidogrel and may influence prognosis of patients treated with clopidogrel. Several studies have examined the association between the C3435T polymorphism and risk of adverse clinical events in clopidogrel treated patients, but the results were inconsistent. To assess the role of the C3435T polymorphism in the impact on clinical outcomes, a meta-analysis was conducted.Methods: 6 studies with 10,153 subjects were included in this meta-analysis. Fixed-or random-effects model was chosen according to heterogeneity. Publication bias was evaluated by fail-safe numbers.Results: The association of the C3435T polymorphism with risk of overall recurrent ischemic events in clopidogrel treated patients was not statistically significant for all genetic models (OR=1.13, 95% CI: 0.78-1.64, P=0.51; OR=1.15, 95% CI: 0.99-1.33, P=0.07; OR=1.19, 95% CI: 0.81-1.76, P=0.37). Significant association was identified between the C3435T polymorphism and risk of short-term recurrent ischemic events (OR=1.55, 95% CI: 1.09-2.20, P=0.01; OR=1.41, 95% CI: 1.06-1.87, P=0.02; OR=1.77, 95% CI: 1.19-2.63, P=0.005). No statistically significant association between the C3435T polymorphism and stent thrombosis (OR=0.79, 95% CI: 0.47-1.32, P=0.37) or bleeding (OR=0.98, 95% CI: 0.79-1.21, P=0.82) was identified.The results may be affected by publication bias.Conclusions: This meta-analysis failed to show an association between the ABCB1 C3435T polymorphism and risk of overall recurrent ischemic events, stent thrombosis or bleeding in clopidogrel treated patients. However, the association between TT homozygotes of the C3435T polymorphismand risk of short-term recurrent ischemic events may exist, but needs more studies to confirm. (C) 2011 Elsevier Ltd. All rights reserved.