Abstract:
OBJECTIVE:The aim of this study was to explore the individual effects of the CYP2C19 G681A polymorphism and omeprazole use and their interaction on clopidogrel responsiveness in acute coronary syndrome (ACS). 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 were limited. METHODS:We conducted a cross-sectional study of 102 ACS patients who received clopidogrel before 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 s. The CYP2C19 G681A polymorphism was investigated using the PCR-RFLP technique. Statistical analysis was performed by using χ 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 47.1 and 37.3% patients, respectively. The mean CT ± SD was 103.1 ± 1.7 s 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 (P = 0.002), but had no significant difference in patients with vs. without omeprazole use (P = 0.467). The ROC analysis of an effect on clopidogrel hyporesponsiveness of CYP2C19 G681A alone and combination with omeprazole use had area under the curve values of 0.654 and 0.672, respectively. CONCLUSION: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.
journal_name
Coron Artery Disjournal_title
Coronary artery diseaseauthors
Jirungda S,Pussadhamma B,Komanasin N,Senthong V,Leuangwatthananon Wdoi
10.1097/MCA.0000000000000808subject
Has Abstractpub_date
2020-05-01 00:00:00pages
266-272issue
3eissn
0954-6928issn
1473-5830journal_volume
31pub_type
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journal_title:Coronary artery disease
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journal_title:Coronary artery disease
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journal_title:Coronary artery disease
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journal_title:Coronary artery disease
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journal_title:Coronary artery disease
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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journal_title:Coronary artery disease
pub_type: 杂志文章,多中心研究
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journal_title:Coronary artery disease
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journal_title:Coronary artery disease
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doi:10.1097/00019501-199508000-00009
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journal_title:Coronary artery disease
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doi:10.1097/MCA.0b013e32832e5c4c
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journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199310000-00013
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journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199502000-00009
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journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199906000-00003
更新日期:1999-06-01 00:00:00
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journal_title:Coronary artery disease
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doi:10.1097/00019501-200512000-00007
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pub_type: 杂志文章
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journal_title:Coronary artery disease
pub_type: 杂志文章
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更新日期:2000-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2018-03-01 00:00:00
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journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-200302000-00010
更新日期:2003-02-01 00:00:00
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journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-200505000-00010
更新日期:2005-05-01 00:00:00
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journal_title:Coronary artery disease
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journal_title:Coronary artery disease
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MCA.0b013e328300dbd3
更新日期:2008-08-01 00:00:00
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journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199809010-00007
更新日期:1998-01-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2019-12-01 00:00:00