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Introduction: Combination of clopidogrel and aspirin has been proven beneficial in treating symptomatic intracranial stenosis. The CYP2C19 polymorphism (CYP2C19*1, CYP2C19*2, CYP2C19*3, and CYP2C19*17 alleles) affects the efficacy of clopidogrel. Although epidemiologic studies of CYP2C19 polymorphism have been conducted in the Thai population, data on the frequency of allelic variants of CYP2C19 in Thai patients with symptomatic intracranial stenosis are lacking.
View Article and Find Full Text PDFA review of clopidogrel resistance in lower extremity arterial disease.
JVS Vasc Insights
January 2024
Manchester Vascular Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
Objective: Lower extremity arterial disease (LEAD) is a prevalent condition that produces a significant burden on health care systems. Patients with LEAD have an increased risk of major adverse cardiovascular events as well as major adverse limb events. Despite significant variation in guidance on antiplatelet therapy for LEAD worldwide, many governing bodies recommend clopidogrel as the preferred single anti-platelet agent.
View Article and Find Full Text PDFDevelopment and Validation of a Rapid Point-of-Care CYP2C19 Genotyping Platform.
J Mol Diagn
December 2024
Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom; Division of Evolution, Infection and Genomics, School of Biological Sciences, University of Manchester, Manchester, United Kingdom. Electronic address:
Pharmacogenetic-guided prescribing can lead to more accurate medicine selection and dosing, improving patient outcomes and leading to better use of health care budgets. Loss-of-function variants in CYP2C19 influence an individual's ability to metabolize clopidogrel, increasing the risk of secondary vascular events following ischemic stroke and percutaneous coronary intervention. In acute clinical contexts, centralized laboratory-based testing is too slow to inform timely clinical decision-making.
View Article and Find Full Text PDFPEAR1, PON1, CYP2C19, CYP1A2 and F2R Polymorphisms are Associated with MACE in Clopidogrel-Treated Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.
Pharmgenomics Pers Med
December 2024
Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
Objective: The objective of this study was to evaluate the impact of clopidogrel-related gene polymorphisms on the occurrence of recurrent thrombotic events and cardiovascular death in patients with acute coronary syndrome (ACS) following percutaneous coronary intervention (PCI).
Methods: We conducted genotype testing for 26 specific loci mapped to 18 clopidogrel-associated genes in ACS patients who had undergone PCI and were receiving dual antiplatelet therapy only involving clopidogrel. We documented major adverse cardiovascular events (MACE) and clinical endpoints, analyzing the effect of genetic polymorphisms on treatment outcomes.
Genotype-Guided P2Y Inhibitor Monotherapy Within 7 Days of Percutaneous Coronary Intervention in High Bleeding Risk Patients: The CHAMP Trial - A Pilot Study and Safety Assessment.
Mayo Clin Proc
January 2025
Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA. Electronic address:
Objective: To test the feasibility and safety of genotype guidance in the selection of P2Y monotherapy within 1 week of percutaneous coronary interventions (PCIs) among patients with high bleeding risk (HBR).
Patient And Methods: The study was a single-center, open-label, pilot trial. Patients (n=100) with HBR (as defined by an academic research consortium) after successful PCI received dual antiplatelet therapy with clopidogrel and aspirin.
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