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KMID : 1034720200120010033
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Journal of Neurosonology and Neuroimaging
2020 Volume.12 No. 1 p.33 ~ p.39
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The Relationship between the Transcranial Doppler Pulsatility Changes and the CYP2C19 Genotype on Clopidogrel Treatment
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Oh Jin-Young
Han Ji-Eun
Kim Tae-Min
Park Joong-Hyun
Baik Jong-Sam
Kim Jeong-Yeon
Park Jae-Hyeon
Han Sang-Won
Kim Eung-Gyu
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Abstract
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Background: We hypothesized that cytochrome P450 2C19 (CYP2C19) polymorphisms in clopidogrel-treated patients would influence cerebral vessel viscosity, which was related to transcranial Doppler (TCD) pulsatility index (PI). Hence, we explored the relationship between the CYP2C19 genotype status and the TCD PI changes in acute ischemic stroke patients on clopidogrel treatment using serial TCD examinations.
Methods: Patients (aged ≥40 years) who developed ischemic stroke within 7 days of onset of symptom from June 2018 to May 2019 were recruited for this study. Patients with high-risk cardiac sources of emboli, or stroke of other determined etiology as a stroke subtype, were excluded from the study. TCD was performed 5 (±2) days and followed up 180 (±30) days after onset of stroke.
Results: Eighty-four patients were enrolled for this study. Patients were categorized into decreased and increased PI groups. Good genotype for clopidogrel metabolism was found in 38% of the decreased-PI patients and 25% of the increased-PI patients (p=0.252). CYP2C19 genotype status was not associated with PI changes in both groups. Hematocrit (Hct) was significantly related to PI changes.
Conclusion: CYP2C19 genotype status was not related to TCD PI changes in acute ischemic stroke patients on clopidogrel treatment. Hct was the major determinant factor of PI. The negative association of Hct with cerebral blood flow velocity and its positive association with blood viscosity are plausible explanations for this phenomenon.
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KEYWORD
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Antithrombotics, Blood viscosity, Hematocrit, Stroke, Ultrasonography
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