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Impact of Continuous P2Y12 Inhibition Tailoring in Acute Coronary Syndrome and Genetically Impaired Clopidogrel Absorption.
- Source :
-
Journal of cardiovascular pharmacology [J Cardiovasc Pharmacol] 2020 Feb; Vol. 75 (2), pp. 174-179. - Publication Year :
- 2020
-
Abstract
- Clopidogrel is still widely used in acute coronary syndrome despite the development of more potent P2Y12 inhibitors. Previously, we conducted a trial that evaluated serial clopidogrel dose adjustment based on platelet function testing in acute coronary syndrome patients with initial high on-treatment platelet reactivity (HTPR). In this substudy, we performed post hoc analysis of the effect of ABCB1 genetic variants C3435T and G2677T/A on platelet inhibition and outcomes. There were no differences in the proportion of HTPR patients among C3435T carriers and noncarriers in both interventional and control group. G2677T carriers expressed significantly higher proportion of HTPR pattern throughout 12-month follow-up in the control group with no difference in the interventional group. There was no difference in ischemic outcomes between C3435T and G2677T carriers and noncarriers in both groups of patients. The results indicate that ABCB1 genotyping is not useful to guide clopidogrel therapy tailoring to improve high-risk patient management.
- Subjects :
- ATP Binding Cassette Transporter, Subfamily B genetics
ATP Binding Cassette Transporter, Subfamily B metabolism
Acute Coronary Syndrome blood
Acute Coronary Syndrome diagnosis
Aged
Blood Platelets metabolism
Clopidogrel metabolism
Drug Monitoring
Female
Humans
Male
Middle Aged
Platelet Aggregation Inhibitors metabolism
Purinergic P2Y Receptor Antagonists metabolism
Randomized Controlled Trials as Topic
Receptors, Purinergic P2Y12 blood
Treatment Outcome
Acute Coronary Syndrome drug therapy
Blood Platelets drug effects
Clopidogrel administration & dosage
Gastrointestinal Absorption genetics
Pharmacogenomic Variants
Platelet Aggregation drug effects
Platelet Aggregation Inhibitors administration & dosage
Purinergic P2Y Receptor Antagonists administration & dosage
Receptors, Purinergic P2Y12 drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1533-4023
- Volume :
- 75
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of cardiovascular pharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 32023226
- Full Text :
- https://doi.org/10.1097/FJC.0000000000000767