Abstract
Objective: To describe the clinical characteristics, neuroimaging findings, and distribution of CYP2C19 gene polymorphisms in patients with ischemic stroke treated at the Bach Mai National Institute of Neuroscience. Methods: A retrospective descriptive study was conducted in 82 patients diagnosed with ischemic stroke who underwent CYP2C19 genotyping at the Neurology Institute, Bach Mai Hospital, between January 2024 and June 2026. Clinical characteristics, neuroimaging findings, and the distributions of CYP2C19 genotypes and metabolizer phenotypes were collected and analyzed using SPSS software. Results: The mean age of the patients was 64,4 ± 12.6 years, and 58.5% were male. Hemiparesis was the most common clinical manifestation (70,7%), followed by aphasia (52,4%) and cranial nerve palsy (50,0%). The median National Institutes of Health Stroke Scale (NIHSS) score at admission was 3 (interquartile range [IQR], 1–5), with 67,1% of patients presenting with mild neurological deficits (NIHSS 0–4). No significant large-vessel stenosis or occlusion was identified in 58,5% of patients, whereas the middle cerebral artery was the most frequently affected vessel (11,0%). Overall, 68,3% of patients carried at least one CYP2C19 loss-of-function allele (*2 or *3). The intermediate metabolizer phenotype was the most prevalent (56.1%), followed by the normal metabolizer (30,5%), poor metabolizer (12,2%), and ultrarapid metabolizer (1,2%) phenotypes. Conclusions: Patients with ischemic stroke in this study were predominantly middle-aged and older men presenting with mild neurological deficits at admission. Cerebral infarctions mainly involved the anterior circulation, and most patients had no significant large-vessel stenosis or occlusion. CYP2C19 polymorphisms were highly prevalent, with the intermediate metabolizer phenotype being the predominant phenotype, consistent with the genetic profile reported in East Asian populations.
