Association between cyclooxygenase gene rs20417 polymorphism and aspirin resistance: a meta-analysis

ABSTRACT

@#Background: Although the association of single nucleotide polymorphisms (SNPs) of cyclooxygenase (COX) genes and the risk of aspirin resistance (AR) has been extensively studied, the results remain conflicting. The majority of studies have focused on the role of rs20417 (COX-2 -G765C) in AR. To derive a more comprehensive and accurate evaluation of this association, we performed a meta-analysis including the most recent studies. Methods: Relevant studies published up to October 2018 were identified by searching the PubMed, EMBASE, Web of Science, Cochrane, China Nation Knowledge Infrastructure Platform, Wanfang, and VIP databases, and by manual searching reference lists of the retrieved articles. Odds ratios (ORs) and 95% confidence intervals (CIs) were applied to assess the strength of associations. Sensitivity and subgroup analyses were performed to explore the stability of results and between-study heterogeneity, respectively. Results: A total of 18 studies on rs20417 were pooled into the meta-analysis. Rs20417 was found to be associated with an increased risk of AR (C vs. G OR = 1.43, 95% CI = 1.10–1.86, p < 0.05; GC+CC vs. GG OR = 1.54, 95% CI =1.15–2.05, p < 0.05). These associations were stronger in Chinese participants and in patients with ischemic stroke in subgroup analyses. Conclusion: The presence of rs20417 indicates an increased risk of AR, especially in Chinese participants and patients with ischemic stroke. This association could help to improve personalized medicine and initiate appropriate treatment as necessary. Further large-scale studies are warranted to confirm our findings.