The efficacy of clopidogrel in preventing recurrent cardiovascular events among Arab population carrying different CYP2C19 mutations: systematic review and meta-analysis

Abstract Background The prevalence and the role of CYP2C19 gene mutations concerning recurrent Cardiovascular Events (CVEs) among patients treated with clopidogrel is still controversial especially Arab people. Therefore, this review aimed to determine frequency polymorphic alleles population investigate efficacy as an antiplatelet drug those carrying different variants gene. Methodology Two authors independently searched in PubMed, Google Scholar, EMBASE databases at any year for studies related on prognosis CVEs clopidogrel. included people who were genotyped genotypes (the qualitative part). Concerning quantitative part (meta-analysis), only previously had using secondary prophylaxis been included. Newcastle Ottawa Scale non-randomizes Studies was utilized consider risk bias studies. We analyzed data odds ratio 95% confidence interval quality evidence each outcome measure judged GRADE approach. Results current study revealed that 4% Arabs reported are homozygous, 25% heterozygous CYP2C19*2 allele. While 3% 18.5% them homozygous CYP2C19*17 alleles, respectively. A significant increased by about threefold associated or CYP2C19*3 allele carriers (OR = 3.32, CI 1.94–5.67, OR 3.53, 1.17–10.63, respectively). However, no mutation 0.80, (CI 0.44–1.44) documented. Conclusion present could be decreasing alternative should prescribed avoid CVEs. few available analysis further large sample size recommended confirm our results.