CYP2C19 is one of the principal enzymes involved in the metabolism of clopidogrel. The genes encoding CYP enzymes are polymorphic, with common alleles conferring reduced function. A loss-of-function allele, CYP2C19*2, is associated with an increased risk of major adverse cardiovascular events, particularly stent thrombosis, in patients with acute coronary syndromes who are receiving clopidogrel, especially among those undergoing percutaneous coronary intervention. Newer, more potent P2Y12 inhibitors like prasugrel and ticagrelor have been introduced recently in the daily clinical practice with better cardiovascular outcome in these patients. The purpose of this review article is to provide information regarding the clinical use of CYP2C19 genotyping in patients requiring antiplatelet therapy.
Background: Current guidelines lack recommendations regarding the use of proton pump inhibitors (PPIs) for preventing upper gastrointestinal bleeding (UGIB) among patients at low risk for UGIB treated with dual antiplatelet therapy for ischemic stroke (IS). Our objective was to assess the effectiveness of PPIs in lowering the risk of significant UGIB in this patient group.
Methods And Results: A retrospective cohort study was conducted involving patients at low risk for UGIB admitted for IS between 2014 and 2018 and treated with dual antiplatelet therapy.
Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China; School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, China. Electronic address:
Background: Dual antiplatelet therapy (DAPT) after coronary artery bypass grafting (CABG), although might be protective for ischemic events, can lead to varying degrees of bleeding, resulting in serious clinical events, including death. This study aims to develop accurate and scalable predictive tools for early identification of bleeding risks during the DAPT period post-CABG, comparing them with the PRECISE-DAPT score..
Background: Lumbar puncture (LP) is a critical diagnostic procedure in the evaluation of neurological diseases. Although considered safe, complications such as post-dural puncture headache (PDPH), back pain, subdural hematoma or venous sinus thrombosis may still occur. Whether the use of antiplatelet therapy (APT) increases the risk of complications after LP, remains unclear.
Anuclear blood cells, platelets, are the basis for the formation of blood clots in human vessels. While antiplatelet therapy is most often used after ischemic events, there is a need for its personalization due to the limited effectiveness and risks of bleeding. Previously, we developed a series of computational models to describe intracellular platelet signaling and a set of experimental methods to characterize the platelets of a given patient.
Atherosclerosis, a major cause of cardiovascular disease (CVD), involves plaque buildup in arteries driven by inflammation, endothelial dysfunction, and lipid metabolism disturbances. Current therapies aim to reduce cholesterol through statins and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, prevent blood clots with antiplatelet drugs like aspirin, and control inflammation, alongside lifestyle modifications. However, these approaches often fall short due to patient non-compliance and residual risks.
