CYP2C19HGNC PubMedRecurrent variantAdverse reaction

The association of ABCB1, CYP2C19 and CYP2C9 combined activity with clopidogrel resistance in patients with recurrent ischemic stroke

Deiman B, Hermans M, de Rijk M, Bras A, Scharnhorst V — Pharmacogenomics J 2026 · June 2026

Relevance score

7/10

Disease / domain

Clopidogrel resistance — recurrent ischemic stroke

Gene–drug pair / mechanism

Combined *ABCB1* / *CYP2C19* / *CYP2C9* interaction identifying cascade phenotypes predictive of clopidogrel resistance

Summary

A prospective case-control study of 402 patients with recurrent ischemic stroke on clopidogrel monotherapy analyzes the combined effect of ABCB1, CYP2C19, and CYP2C9 genes on clopidogrel resistance. The combined activity of all three genes identifies cascade phenotypes associated with resistance (p<0.001–0.019) with greater precision than any single gene. These results argue for multi-gene genotyping rather than CYP2C19-only testing in this context.

Synthesis written by Geno'X. For the full original abstract, please refer to the source publication.

Analysis

The ABCB1/CYP2C19/CYP2C9 cascade interaction in clopidogrel resistance is a strong argument for adopting multi-gene panels in cardiovascular pharmacogenetics. This well-conducted study in a population of 402 patients with a hard clinical endpoint (stroke recurrence) strengthens the clinical relevance of multi-enzyme genotyping.

Why this score?

Clinical impact: 2/3 · Evidence strength: 2/3 · Novelty: 1/2 · Sample size: 1/1 · Publication status: 1/1 → Total: 7/10

Keywords

CYP2C19ABCB1clopidogrelstroketreatment resistance