Association of ABCB1 gene polymorphisms with aspirin or clopidogrel resistance in ischemic stroke: a meta-analysis.

Abstract

<h4>Objective</h4>Ischemic stroke (IS) is a major public health concern worldwide. In this study, we aimed to investigate the relationship between <i>ABCB1</i> gene polymorphisms and antiplatelet resistance in patients with IS.<h4>Methods</h4>We performed a comprehensive search of the PubMed, China National Knowledge Infrastructure, Web of Science, and WANFANG databases for articles published until February 2024. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were used to measure the association between <i>ABCB1</i> polymorphisms and antiplatelet resistance in patients with IS. All the statistical analyses were performed using STATA version 11.0.<h4>Results</h4>Eleven studies containing 2,228 cases and 2,556 controls met the inclusion criteria. Our results showed that aspirin resistance in patients with IS was significantly correlated with the polymorphism of <i>ABCB1</i> rs1045642 (Allele model: OR=1.5, 95% CI [1.10, 2.05], P=0.010; Homozygote model: OR=2.02, 95% CI [1.01, 4.05], P=0.047; Heterozygote model: OR=1.37, 95% CI [0.91, 2.08], P=0.132; Dominant model: OR=1.75, 95% CI [1.09, 2.81], P=0.021; Recessive model: OR=1.61, 95% CI [1.01, 2.57], P=0.045). Meanwhile, we found that <i>ABCB1</i> rs1045642 polymorphism might be significantly associated with clopidogrel resistance in IS (A. Homozygote model: OR=3.35, 95% CI [1.99, 5.63], P=0.000; B. Heterozygote model: OR=0.81, 95% CI [0.54, 1.21], P=0.895; C. Dominant model: OR=1.41, 95% CI [0.59, 3.36], P=0.435; D. Recessive model: OR=3.43, 95% CI [2.14, 5.51], P=0.000).<h4>Conclusion</h4>This meta-analysis suggests a potential link between <i>ABCB1</i> rs1045642 polymorphism and resistance to clopidogrel or aspirin in patients with IS.