Research Article

Gene-Drug Interaction in Stroke

Table 3

Tissue plasminogen activator.

Author’s name/study nameOutcomeGene (Variant)Sample Size/drugEffect estimates and findings

Broderick et al.
2001 [26]
Favourable outcome (NIHSS of 0 or 1, Barthel Index of 95 or 100, Modified Rankin Scale of 0 or 1, and a Glasgow Outcome Scale of 1.)ApoE (E2, E3, E4)409 ischemic stroke/rTPA versus PB
within 3 hours
ApoE E2 phenotype-rt-PA interaction was associated with good outcome at 3 months (OR: 6.4; 95% CI: 2.7–15.3).
Apo E4 phenotype not related to favorable 3 month outcome, response to t-PA, 3-month mortality, or risk of intracerebral hemorrhage

Fernández-Cadenas et al. [27]Recanalization rate, NIHSS at 48 hours and mRS score at 3 months, heamorrhagic transformationApoE (E2, E3, E4)77 ischemic stroke/rTPA within 3 hours No significant association of ApoE genotype and the studied outcome

Del Río Espínola et al. [28]Reocclusion rate236 SNPs form candidate genes for vascular risk factor222 ischemic stroke/rTPArs1883832 SNP from CD40 gene (OR: 0.077; 95% CI: 0.009–0.66) and rs1800801 SNP from the MGP gene (OR 15.25; 95% CI: 2.23–104.46) were independently associated with reocclusion after adjustment for clinical predictors

Fernández-Cadenas et al. [29]RecanalizationACE (I/D)96 ischemic stroke/rTPA
within 3 hours
ACE DD homozygosis was significantly associated with recanalization rate following rTPA (OR: 4.3 95% CI: 1.35–13.49).
No relation was found between ACE I/D polymorphism and symptomatic hemorrhagic complications. No association between ACE genotypes and Factor VII or Factor X activities

Fernández-Cadenas et al. [30]RecanalizationPAI-1 4G/5G
TAFI (Thr325Ile)
139 with ischemic stroke/TPA within 3 hoursPAI-1 4 G/5 G was not associated with recanalization.
TAFI Thr325Ile polymorphism was associated with recanalization resistance (OR 5.6 95% CI 1.2–20). Combination of TAFI and PAI-1 polymorphisms double the risk of absence of recanalization (OR: 11.1; 95% CI: 1.4–89.8)

González-Conejero et al. [31]Death, recanalizationFactor XIII (FXIII) V34L200 with ischemic stroke/TPA within 3 hoursFXIII 34 L carriers had higher death risk than V/V (OR 2.50 95% CI 1.00–7.06); high fibrinogen levels higher risk than lower levels (OR 2.72 95% CI 1.01–7.44); FXIII 34L and high fibrinogen level higher risk than FXII V and low fibrinogen (OR 5.74 95% CI 1.51–11.56).
No difference in recanalization rate

Montaner et al. [32]Hemorrhagic transformationMMP9 (C1562T)61 with ischemic stroke/TPA within 3 hoursThe polymorphism studied does not increase hemorrhagic risk