TABLE 2.
Meta-analyses of CYP2C19—clopidogrel outcomes studies
| Citation | Pt Population in Meta-analysis (Sample Sizea) | CYP2C19*2c Genotype Relative Risk for MACE (95% CI) | CYP2C19*17 Genotype Relative Risk for MACE, Stent Thrombosis (ST), and/or Bleeding (95% CI) | CYP2C19*2c Genotype Relative Risk for Stent Thrombosis (95% CI) |
|---|---|---|---|---|
| Hulot et al., 2010 | Established CAD (n = 11,959) | *2 carrier: 1.29 (1.12–1.49) | NA | n = 4905 |
| *1*2: 1.59 (0.88–2.88) | *2 carrier: 3.45 (2.14–5.57) | |||
| *2*2: 2.05 (1.15–3.63) | *1*2: 3.34 (1.84–5.93) | |||
| *2*2: 4.68 (1.55–14.11) | ||||
| Sofi et al., 2011d | Established CAD (n = 8043) | *2 carrier: 1.96 (1.14–3.37) | NA | n = 4.975 |
| *2 carrier: 3.82 (2.23–6.54) | ||||
| Mega et al., 2010 | Aggressively managed CAD patients (n = 9685) | *2 carrier: 1.57 (1.13–2.16) | NA | n = 6094 |
| *1*2: 1.55 (1.11–2.17) | *2 carrier: 2.81 (1.81–4.37) | |||
| *2*2: 1.76 (1.24–2.50) | *1*2: 2.67 (1.69–4.22) | |||
| *2*2: 3.97 (1.75–9.02) | ||||
| Bauer et al., 2011 | Established CAD (n = 18,529) | *2 carrier: 1.11 (0.89–1.39) | *17 carrier (n = 9128) | n = 19,328 |
| MACE: 0.93 (0.75–1.14) | *2 carrier: 1.77 (1.31–2.40) | |||
| ST: 0.99 (0.60–1.62) | ||||
| Liu et al., 2011 | Established CAD (n = 24,120) | *2 carrier: 1.26 (1.06–1.50) | *17 carrier (n = NR) | ST n = NR |
| MACE: 0.82 (0.69–0.98) | *2 carrier: 2.58 (1.77–3.77) | |||
| Holmes et al., 2011 | Unselectedb (n = 26,251) | *2 carrier: 1.18 (1.09–1.28) | NA | n = 16,008 |
| *2 carrier: 1.75 (1.50–2.03) | ||||
| Li et al., 2012 | Established CAD (n = 9428) | NA | *17 carrier: (n = 9428) MACE: 0.82 (0.72–0.94) | NA |
| Bleeding: 1.25 (n = 12,228)(1.07–1.47) | ||||
| Zabalza et al., 2012d | Established CAD (n = 16,360) | 1.23 (0.97–1.55) | *17 carrier (n = 7660): | n = 8686 |
| MACE: 0.75 (0.66–0.87) | *2 carrier: 2.24 (1.52–3.30) | |||
| Bleeding: 1.26 (1.05–1.50) |
NA, not assessed; NR, not reported; ST, stent thrombosis.
a
Indicates largest sample size in the analysis; usually for *2 carrier status.
b
This meta-analysis included all studies of clopidogrel pharmacogenetics, independent of patient disease status or indication for clopidogrel; excluded studies with stent thrombosis as primary endpoint. Data reported are treatment only analysis with fixed effects model.
c
*2 refers to any loss of function allele, among which *2 represents the vast majority.
d
Meta-analyses are listed by online publication year. In some cases the final print manuscript was published the following year.