Full Length ArticleAssociation between CYP3A5 polymorphisms and the risk of adverse events in patients undergoing clopidogrel therapy: Meta-analysis

•It was the first time to evaluate the association between CYP3A5 rs776746 polymorphism and adverse events of clopidogrel therapy.•There was no significant correlation between CYP3A5 rs776746 polymorphism and major adverse events of clopidogrel therapy.•No sufficient evidence was found to judge the relationship among rs776746 polymorphism and bleeding events or clopidogrel resistance.

IntroductionWe wished to explore the relationship between CYP3A5 polymorphisms and adverse events in patients undergoing clopidogrel therapy.MethodsA Boolean search of the PubMed, EMbase, OVID and Cochrane Library databases was conducted in April 2016. The primary outcome was major adverse cardiovascular events (MACE). The secondary outcome was bleeding events and resistance to the effects of clopidogrel. The CYP3A5 polymorphism was classified into three types: wild-type (AA), heterozygote (AG) and homozygous mutant (GG). We estimated pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) using the Mantel-Haenszel model.ResultsTwelve studies involving 8284 patients were eligible for our meta-analysis. CYP3A5 polymorphisms had no obvious influence on MACE (AA + AG vs. GG: OR = 1.032, 95% CI = 0.583-1.824, p = 0.915; AA vs. AG + GG: 1.415, 0.393-5.094, 0.595). There was no significant relationship between CYP3A5 polymorphisms and bleeding (GG vs. AA + AG: OR = 0.798, 95% CI = 0.370-1.721, p = 0.565) or clopidogrel resistance (AA + AG vs. GG: 1.009, 0.685-1.488, 0.963; AA vs. AG + GG, 0.618, 0.368-1.039, 0.069).ConclusionNo significant correlation was found between CYP3A5 polymorphisms and adverse events due to clopidogrel therapy.