title: Association between CYP3A5 polymorphisms and the risk of adverse events in patients undergoing clopidogrel therapy: Meta-analysis.
abstract: BACKGROUND
  We wished to explore the relationship between CYP3A5 polymorphisms and adverse events in patients undergoing clopidogrel therapy.
  
  
  METHODS
  A Boolean search of the PubMed, EMbase, OVID and Cochrane Library databases was conducted in April 2016. The primary outcome was major adverse cardiovascular events (MACE). The secondary outcome was bleeding events and resistance to the effects of clopidogrel. The CYP3A5 polymorphism was classified into three types: wild-type (AA), heterozygote (AG) and homozygous mutant (GG). We estimated pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) using the Mantel-Haenszel model.
  
  
  RESULTS
  Twelve studies involving 8284 patients were eligible for our meta-analysis. CYP3A5 polymorphisms had no obvious influence on MACE (AA+AG vs. GG: OR=1.032, 95% CI=0.583-1.824, p=0.915; AA vs. AG+GG: 1.415, 0.393-5.094, 0.595). There was no significant relationship between CYP3A5 polymorphisms and bleeding (GG vs. AA+AG: OR=0.798, 95% CI=0.370-1.721, p=0.565) or clopidogrel resistance (AA+AG vs. GG: 1.009, 0.685-1.488, 0.963; AA vs. AG+GG, 0.618, 0.368-1.039, 0.069).
  
  
  CONCLUSIONS
  No significant correlation was found between CYP3A5 polymorphisms and adverse events due to clopidogrel therapy.
authors.affiliation: Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.
authors.forename: Yin-Qing
authors.initials: YQ
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.
authors.forename: Chun-Hua
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China. Electronic address: pollyzhang2006@126.com.
authors.forename: Jin-Hua
authors.initials: JH
authors.lastname: Zhang
mesh_terms: D000077144:Clopidogrel; D051544:Cytochrome P-450 CYP3A / Q000235:genetics*; D004351:Drug Resistance; D056726:Genetic Association Studies; D006470:Hemorrhage / Q000139:chemically induced / Q000235:genetics; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D020641:Polymorphism, Single Nucleotide; D058921:Purinergic P2Y Receptor Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D000077144:Clopidogrel; D051544:Cytochrome P-450 CYP3A; D013988:Ticlopidine
keywords: CYP3A5; Clopidogrel; Genetic polymorphism; Meta-analysis; rs776746