Clopidogrel utilization in patients with coronary artery disease and diabetes mellitus: should we determine CYP2C19*2 genotype?
| العنوان: | Clopidogrel utilization in patients with coronary artery disease and diabetes mellitus: should we determine CYP2C19*2 genotype? |
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| المؤلفون: | Khaldoun Ben Hamda, Mohsen Hassine, Sondess Hadj Fredj, Marwa Rezek, Taieb Messaoud, Linda Khefacha, Fadoua Neffeti, A. Sriha, Mayssa Gaaloul, Ilhem Hellara, Mouna Sassi, Faouzi Maatouk, Rym Dabboubi, Fatma Abderrazak, Saoussen Chouchene, Haythem Raddaoui, Mohamed Fadhel Najjar, H. Abroug, Semir Nouira |
| المصدر: | European Journal of Clinical Pharmacology. 74:1567-1574 |
| بيانات النشر: | Springer Science and Business Media LLC, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Adult, Blood Platelets, Male, Heterozygote, medicine.medical_specialty, Genotype, Platelet Function Tests, Coronary Artery Disease, CYP2C19, 030204 cardiovascular system & hematology, Gastroenterology, Coronary artery disease, Young Adult, 03 medical and health sciences, 0302 clinical medicine, P2Y12, Diabetes mellitus, Internal medicine, Diabetes Mellitus, medicine, Humans, Pharmacology (medical), Platelet, 030212 general & internal medicine, Aged, Pharmacology, Polymorphism, Genetic, business.industry, General Medicine, Odds ratio, Middle Aged, Clopidogrel, medicine.disease, Cytochrome P-450 CYP2C19, Cross-Sectional Studies, Female, business, Diabetic Angiopathies, Platelet Aggregation Inhibitors, medicine.drug |
| الوصف: | Clopidogrel non-responsiveness is multifactorial; several genetic and non-genetic factors may contribute to impaired platelet inhibition. The goal of this study is to determine the effect of the cytochrome P450 CYP2C19*2 polymorphism on the platelet response to clopidogrel in patients with and without diabetes mellitus (DM). We conducted an observational study in patients with coronary artery disease and consequent exposure to clopidogrel therapy (75 mg/day for at least 7 consecutive days). We have analyzed two groups of patients: group I (DM patients) and group II (non-diabetes mellitus patients). Platelet reactivity was assessed by the VerifyNow P2Y12 assay and high on clopidogrel platelet reactivity (HPR) was defined as P2Y12 reaction units (PRU) ≥ 208. Genotyping for CYP2C19*2 polymorphism was performed by PCR-RFLP. We have included 150 subjects (76 DM and 74 non-diabetes mellitus patients). The carriage of CYP2C19*2 allele, in DM patients, was significantly associated to HPR (odds ratio (OR) 4.437, 95% confidence interval (CI) 1.134 to 17.359; p = 0.032). Furthermore, 8.4% of the variability in percent inhibition by clopidogrel could be attributed to CYP2C19*2 carrier status. However, in non-diabetes mellitus patients, there was no significant difference in platelet response to clopidogrel according to the presence or absence of CYP2C19*2 allele carriage (OR 1.260, 95% CI 0.288 to 5.522; p = 0.759). Our study suggests that the carriage of CYP2C19*2 polymorphism, in DM patients, might be a potential predictor of persisting HPR in these high-risk individuals. Clinical Trials.gov NCT03373552 (Registered 13 December 2017) |
| تدمد: | 1432-1041 0031-6970 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3644bce37f1445df74bd4faaa4fa12beTest https://doi.org/10.1007/s00228-018-2530-5Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....3644bce37f1445df74bd4faaa4fa12be |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14321041 00316970 |
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