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April 11, 2012

CYP2C19 Genotype and Cardiovascular Events—Reply

Author Affiliations

Author Affiliations: Department of Epidemiology and Public Health, University College London, London, England (mvholmes@gmail.com).

JAMA. 2012;307(14):1482-1485. doi:10.1001/jama.2012.446

In Reply: We considered all included trials to be within the remit of our systematic review, including those involving patients receiving clopidogrel for indications other than PCI.13 However, based on the letters from Dr Shuldiner and Dr Mega and their colleagues, we excluded these studies, which yielded a summary relative risk (RR) of 1.22 (95% CI, 1.11-1.33) for the association of CYP2C19 genotype with cardiovascular disease (CVD) events. The addition of the 3 studies alluded to by Mega et al, excluded by us because they focused solely on stent thrombosis, yielded a summary RR of 1.21 (95% CI, 1.12-1.30) for CVD events. These modest effect estimates also remain affected by small-study bias.

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