CYP2C19 genotype-guided escalation to ticagrelor vs. clopidogrel in secondary stroke prevention: a retrospective cohort study.

ABSTRACT:

Objective

To evaluate the effectiveness and safety of an antiplatelet therapy strategy guided by CYP2C19 genotyping in the secondary prevention of ischemic stroke in a real-world setting.

Methods

This single-center retrospective cohort study enrolled 623 ischemic stroke patients. Based on their CYP2C19 genotype (extensive metabolizer [EM], intermediate metabolizer [IM], poor metabolizer [PM]) and the actual P2Y12 receptor antagonist treatment received (clopidogrel or ticagrelor), patients were categorized into natural cohorts. To minimize confounding, we applied propensity score matching, yielding a final analysis cohort of 514 patients. The primary outcome was the incidence of major adverse cardiovascular events (MACE), including stroke recurrence, myocardial infarction, an

SUBMITTER: Haidong S 

PROVIDER: S-EPMC12920421 | biostudies-literature | 2026

REPOSITORIES: biostudies-literature