P2Y12 receptor gene polymorphism and the risk of resistance to clopidogrel: A meta-analysis and review of the literature.

A number of investigators have evaluated the association between T744C, G52T and C34T polymorphisms in the P2Y12 receptor gene and clopidogrel resistance (CR), but the results of their research are controversial. To quantify the evidence addressing this issue, we performed a meta-analysis of all available studies to evaluate the above association between the 3 different P2Y12 genotypes and CR in patients suffering from cardiovascular diseases. This study included articles up to October 2015. We performed a systematic search of PubMed, Embase, Web of Science, Cochrane database, China National Knowledge Infrastructure (CNKI) and WanFang database. Articles meeting the inclusion criteria were included and accumulated by meta-analysis including 5769 participants from 15 individual studies. For G52T polymorphism, a significant relationship between the P2Y12 receptor gene and CR was found under the dominant genetic model (p < 0.05). There was a clear positive correlation between the C34T polymorphism and CR under the dominant, recessive, additive genetic models, respectively (p < 0.05). The evidence from the present metaanalysis indicates that P2Y12 receptor gene C34T and G52T polymorphism might be a risk factor for the poor response to the platelet in patients on clopidogrel therapy, whereas a lack of association was found for T744C polymorphism examined by various genetic models.