Deans' stroke musings: Pharmacogenetics polygenic response score predicts outcomes in aspirin-treated stroke patients

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, April 2, 2025

Pharmacogenetics polygenic response score predicts outcomes in aspirin-treated stroke patients

Will your competent? doctor use this to predict the usefulness of aspirin in preventing the next stroke?

Pharmacogenetics polygenic response score predicts outcomes in aspirin-treated stroke patients

Rui-Nan Ma1†, Dong Zhang1†, Zhi-Zhang Li1†, Ying Ding1, Xiao-Guang Zhang1, Jie Xue1, Dan-Zhuoma Ci1, Yue-Ying Bai2, Liang Hu1*, Dai-Zhan Zhou1* and Yun-Hua Yue1*

1Department of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China

2Biology Department, Boston College, Chestnut Hill, MA, United States

Edited by:

Farhad Kamali, Newcastle University, United Kingdom

Reviewed by:

Andy R. Eugene, Larned State Hospital, United States

Katy Sanchez-Pozos, Hospital Juárez de México, Mexico

* Correspondence: Liang Hu, 13585696649@163.com; Dai-Zhan Zhou, zhoudaizhan@163.com; Yun-Hua Yue, Yunhua.Yue@tongji.edu.cn

†These authors have contributed equally to this work and share first authorship

Received: 29 October 2024

Accepted: 19 February 2025

Published: 01 April 2025

Citation: Ma R-N, Zhang D, Li Z-Z, Ding Y, Zhang X-G, Xue J, Ci D-Z, Bai Y-Y, Hu L, Zhou D-Z and Yue Y-H (2025) Pharmacogenetics polygenic response score predicts outcomes in aspirin-treated stroke patients. Front. Pharmacol. 16:1519383. doi: 10.3389/fphar.2025.1519383

Background:

Aspirin is a cornerstone medication for acute ischemic stroke (AIS), but its efficacy varies significantly among individuals. This study aimed to develop a pharmacogenetic polygenic response score (PgxRS) to predict the incidence of adverse outcomes in aspirin-treated AIS patients.

Methods:

We conducted a retrospective study involving 828 AIS patients who received aspirin therapy. Fifteen candidate single nucleotide variants (SNPs) in genes related to aspirin’s mechanism of action, transport, metabolism, and platelet function were genotyped. The association between SNPs and the risk of unfavorable prognosis (defined as modified Rankin Scale score >1 at 90 days) was assessed using logistic regression analysis. Multivariable models incorporating SNPs and clinical factors were developed to predict adverse outcomes.

Results:

The rs1045642GG genotype in the ABCB1 gene was significantly associated with a lower risk of unfavorable prognosis, while the rs1371097T allele in the P2Y1 gene was linked to a higher risk. A prediction model incorporating these two SNPs along with clinical variables demonstrated moderate diagnostic accuracy for predicting unfavorable prognosis (AUC = 0.78, 95% CI: 0.74–0.81).

Conclusion:

Our findings suggest that rs1045642 and rs1371097 genotypes contribute to variability in aspirin response among AIS patients. The developed PgxRS, incorporating these SNPs and clinical factors, can potentially aid in risk stratification and guide personalized antiplatelet therapy decisions. However, further validation in larger, diverse cohorts is warranted.