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Publication
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| Title of Article |
Interaction of CYP2C19 G681A polymorphism and omeprazole on clopidogrel responsiveness and impact in patients with acute coronary syndrome |
| Date of Acceptance |
8 September 2019 |
| Journal |
| Title of Journal |
Coronary Artery Disease |
| Standard |
ISI |
| Institute of Journal |
Lippincott Williams & Wilkins Ltd. |
| ISBN/ISSN |
0954-6928 |
| Volume |
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| Issue |
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| Month |
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| Year of Publication |
2019 |
| Page |
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| Abstract |
Objective: To explore the individual effects of the CYP2C19 G681A polymorphism and omeprazole use and their interaction on clopidogrel responsiveness in acute coronary syndrome (ACS) patients.
Background: The CYP2C19 G681A polymorphism and omeprazole use were both known for retarding the effects of clopidogrel under broad cardiovascular conditions; however, data from ACS patients was limited.
Methods: We conducted a cross-sectional study of 102 ACS patients who received clopidogrel prior to percutaneous coronary intervention. The platelet function was assessed by a Platelet Function Analyzer-200, in which clopidogrel hyporesponsiveness was defined as a closure time (CT) of ≤106 seconds. The CYP2C19 G681A polymorphism was investigated using the PCR-RFLP technique. Statistical analysis was performed by Chi-square test, Student’s t-test, binary logistic regression, and receiver-operating characteristic (ROC) curve.
Results: Carriages of the CYP2C19 681A allele and omeprazole use were present in 48 (47.1%) and 38 (37.3%) patients, respectively. The mean CT±SD was 103.1±1.7 seconds and the prevalence of clopidogrel hyporesponsiveness was 66.7%. The CT was significantly shorter in carriages of the 681A allele compared with the 681G allele (87.1±1.5 vs. 119.9±1.8, P = 0.002), but had no significant difference in patients with vs. without omeprazole use (97.8±1.8 vs. 106.3±1.4, P = 0.467). The ROC analysis of an effect on clopidogrel hyporesponsiveness of CYP2C19 G681A alone and combination between CYP2C19 G681A and omeprazole use had AUC (95% CI) values of 0.654 (0.543 to 0.766), P = 0.011, and 0.672 (0.564 to 0.779), P = 0.005, respectively.
Conclusions: In ACS patients, the effect of the CYP2C19 G681A polymorphism on clopidogrel responsiveness, but not omeprazole use, is strong. However, a combination of both factors enhances clopidogrel hyporesponsiveness.
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| Keyword |
acute coronary syndrome, clopidogrel, CYP2C19, omeprazole, polymorphism |
| Author |
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| Reviewing Status |
มีผู้ประเมินอิสระ |
| Status |
ได้รับการตอบรับให้ตีพิมพ์ |
| Level of Publication |
นานาชาติ |
| citation |
false |
| Part of thesis |
true |
| Attach file |
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| Citation |
0
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Journal Publication
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