ABCB1 C3435T polymorphism and risk of adverse clinical events in clopidogrel treated patients: a meta-analysis.
BACKGROUND
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 polymorphism and risk of short-term recurrent ischemic events may exist, but needs more studies to confirm.
Department of Neurology, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
Man
M
Luo
Jiaoxing
J
Li
Xiaowei
X
Xu
Xunsha
X
Sun
Wenli
W
Sheng
D018435:ATP Binding Cassette Transporter, Subfamily B; D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000235:genetics* / Q000378:metabolism*; D054058:Acute Coronary Syndrome / Q000188:drug therapy / Q000201:enzymology / Q000235:genetics; D000077144:Clopidogrel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011379:Prognosis; D012307:Risk Factors; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics
C513055:ABCB1 protein, human; D018435:ATP Binding Cassette Transporter, Subfamily B; D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000077144:Clopidogrel; D013988:Ticlopidine