首页|Effect of plateletcrit and methylenetetrahydrofolate reductase(MTHFR)C677T genotypes on folic acid efficacy in stroke prevention

Effect of plateletcrit and methylenetetrahydrofolate reductase(MTHFR)C677T genotypes on folic acid efficacy in stroke prevention

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Previous studies have shown that low platelet count combined with high plasma total homocysteine(tHcy)increased stroke risk and can be lowered by 73％with folic acid.However,the combined role of other platelet activation parameters and the methylenetetrahydrofolate reductase(MTHFR)C677T genotypes on stroke risk and folic acid treatment benefit remain to be examined.This study aimed to investigate if platelet activation parameters and MTHFR genotypes jointly impact folic acid treatment efficacy in first stroke prevention.Data were derived from the China Stroke Primary Prevention Trial.This study includes a total of 11,185 adult hypertensive patients with relevant platelet activation parameters and MTHFR genotype data.When simultaneously considering both platelet activation parameters(plateletcrit,platelet count,mean platelet volume,platelet distribution width)and MTHFR genotypes,patients with both low plateletcrit(Q1)and the TT genotype had the highest stroke incidence rate(5.6％)in the enalapril group.This subgroup significantly benefited from folic acid treatment,with a 66％reduction in first stroke(HR:0.34;95％Cl:0.14-0.82;p=0.016).Consistently,the subgroup with low plateletcrit(Q1)and the CC/CT genotype also benefited from folic acid treatment(HR:0.40;95％Cl:0.23-0.70;p=0.001).In Chinese hypertensive adults,low plateletcrit can identify those who may greatly benefit from folic acid treatment,in particular,those with the TT genotype,a subpopulation known to have the highest stroke risk.

Yuncong Shi、Zhengzhipeng Zhang、Binyan Wang、Yu Wang、Xiangyi Kong、Yong Sun、Aimin Li、Yimin Cui、Yan Zhang、Jianping Li、Yong Huo、Hui Huang

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Cardiovascular Department,The Eighth Affiliated Hospital,Joint Laboratory of Guangdong-Hong Kong-Macao Universities for Nutritional Metabolism and Precise Prevention and Control of Major Chronic Diseases,Sun Yat-sen University,Shenzhen,China

Shenzhen Evergreen Medical Institute,Shenzhen,China

Shenzhen Tailored Medical Laboratory,Shenzhen,China

Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing,China

Department of Neurosurgery,The First Affiliated Hospital of Kangda College of Nanjing Medical University,Lianyungang,China

Institute of Clinical Pharmacology,Peking University First Hospital,Beijing,China

Department of Cardiology,Peking University First Hospital,Beijing,China

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National Nature Science Foundation of ChinaNational Nature Science Foundation of ChinaNational Nature Science Foundation of ChinaNational Key Research and Development ProgramShenzhen Key Laboratory of Precision Prevention and Control of Major Chronic Diseases and Metabolic ResearchCentral Military Commission Key Project of Basic Research for ApplicationRegional Joint Funding Key Project of Guangdong Basic Research and Basic Research for ApplicationKey Project of Sustainable Development Science and Technology of Shenzhen Science and Technology Innovation CommitteeShenzhen Science and Technology ProgramShenzhen Science and Technology ProgramShenzhen Medical Research FundShenzhen Key Medical Discipline Construction FundSun Yatsen University-Shenzhen TAILORED Medical LtdPostgraduate joint training baseFutian District Public Health Scientific Research Project of ShenzhenDepartment of Cardiology,Joint Laboratory of Guangdong-Hong Kong-Macao Universities for Nutritional Metabolism and Precise PreveEighth Affiliated Hospital of Sun Yatsen University,ShenzhenChinese Association of Integrative Medicine-Shanghai Hutchison Pharmaceuticals FundChina Heart House-Chinese Cardiovascular Association HX fundShenzhen Medical Research Fundfifth"333"highlevel talent training project of Jiangsu ProvinceMedical Research Project of Jiangsu Provincial Health Commission in 2020

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2024

10.1038/s41392-024-01817-0

信号转导与靶向治疗(英文)

信号转导与靶向治疗(英文)

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ISSN：
年,卷(期)：2024.9(6)