Clopidogrel Preventive Effect Based on CYP2C19 Genotype in Ischemic Stroke

Status Completed

Clinical Trial Summary

The hypothesis of this study is that "the poor metabolizer or intermediate metabolizer of the cytochrome P450 2C19 genotype in patients with acute ischemic stroke is associated with increased risk of composite cardiovascular events (recurrent stroke, myocardial infarction, cardiovascular death) compared to those who of extensive metabolizer of the cytochrome P450 2C19 genotype".

Clinical Trial Description

Clopidogrel, one of the antiplatelet agents used for secondary prevention in patients with ischemic stroke and coronary artery disease, has been shown to have a superior antiplatelet effect compared to aspirin, and is therefore being administered to many patients with stroke and coronary artery disease. Clopidogrel inhibits platelet-derived ADP receptor, P2Y12, in the liver to produce an anti-platelet effect. It has been suggested that clopidogrel resistance could be occurred from drug-drug interaction via the same pharmacological metabolic pathway. Previous studies reported that the genotypes of Cytochrome P450 2C19, which is involved in the metabolism of clopidogrel in the liver, lead to differences in drug response and recurrence rates of cardiovascular disease. The risk of recurrence of ischemic stroke was reported to be about 4 times higher in patients with a poor metabolizer or intermediate metabolizer genotype of the Cytochrome P450 2C19 genotype compared to the extensive metabolizer genotype. This genotypes of Cytochrome P450 2C19 were also different according to race. The researches about cytochrome P450 2C19 genotype and clopidogrel resistance have been conducted mainly in patients with coronary artery disease and are not known in stroke patients. Few studies have examined whether the resistance of clopidogrel according to the genotype of cytochrome P450 2C19 in stroke patients is related to the occurrence and/or recurrence of cardiovascular disease. The hypothesis of this study is that "the poor metabolizer or intermediate metabolizer of the cytochrome P450 2C19 genotype in patients with acute ischemic stroke is associated with increased risk of cardiovascular disease and mortality compared to those who of extensive metabolizer of the cytochrome P450 2C19 genotype". ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT04072705
Study type	Observational
Source	Gangnam Severance Hospital
Contact
Status	Completed
Phase
Start date	September 20, 2019
Completion date	July 7, 2023

View Details

See also
Status	Clinical Trial	Phase
Recruiting	`NCT06113848` - Adjunctive Use of Intra-Arterial TNK and Albumin Following Thrombectomy	Phase 3
Completed	`NCT04069546` - The Efficacy of Remote Ischemic Conditioning on Stroke-induced Immunodeficiency	N/A
Active, not recruiting	`NCT05700097` - Dengzhanxixin Injection for Acute Ischemic Stroke Receiving Reperfusion Therapy	Phase 2
Recruiting	`NCT06058130` - Combination of Antiplatelet and Anticoagulation for AIS Patients Witn Concomitant NVAF and Extracranial/Intracranial Artery Stenosis	N/A
Recruiting	`NCT04415164` - Evaluation of Xueshuantong in Patients With AcutE IschemiC STroke	Phase 4
Recruiting	`NCT05363397` - Safety and Tolerability of Adjunctive TBO-309 in Reperfusion for Stroke	Phase 2
Completed	`NCT05429658` - Single Arm Trial to Evaluate the Safety and Effectiveness of the Route 92 Medical Reperfusion System	N/A
Recruiting	`NCT05390580` - Neuromodulation Using Vagus Nerve Stimulation Following Ischemic Stroke as Therapeutic Adjunct	N/A
Enrolling by invitation	`NCT05515393` - A Study of XY03-EA Tablets in the Treatment of Acute Ischemic Stroke	Phase 2
Active, not recruiting	`NCT05070260` - ACTISAVE: ACuTe Ischemic Stroke Study Evaluating Glenzocimab Used as Add-on Therapy Versus placEbo	Phase 2/Phase 3
Terminated	`NCT05547412` - Validation of Velocity Curvature Index as a Diagnostic Biomarker Tool for Assessment of Large Vessel Stroke
Completed	`NCT03366818` - New Stent Retriever, VERSI System for AIS	N/A
Not yet recruiting	`NCT05293080` - Early Treatment of Atrial Fibrillation for Stroke Prevention Trial in Acute STROKE	Phase 3
Not yet recruiting	`NCT06040476` - Human Umbilical Cord Blood Infusion in Patients With Acute Ischemic Stroke (AIS)	Phase 2
Not yet recruiting	`NCT06437431` - Glenzocimab in Anterior Stroke With Large Ischemic Core Eligible for Endovascular Therapy	Phase 2/Phase 3
Completed	`NCT02223273` - Brazilian Intervention to Increase Evidence Usage in Practice - Stroke (BRIDGE-Stroke)	N/A
Completed	`NCT02586233` - Study to Assess the Safety, Pharmacokinetics, and Pharmacodynamics of DS-1040b in Subjects With Acute Ischemic Stroke	Phase 1/Phase 2
Not yet recruiting	`NCT01594190` - Physical Activity Immediately After Acute Cerebral Ischemia	N/A
Terminated	`NCT01694381` - Research Into the Effect of a Clot-dissolving Agent and Its Inhibitor	Early Phase 1
Completed	`NCT01120301` - Efficacy and Safety Trial of Transcranial Laser Therapy Within 24 Hours From Stroke Onset (NEST-3)	Phase 3