دورية أكاديمية
Factors associated with clopidogrel resistance and clinical outcomes in ischemic cerebrovascular disease: A retrospective study.
| العنوان: | Factors associated with clopidogrel resistance and clinical outcomes in ischemic cerebrovascular disease: A retrospective study. |
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| المؤلفون: | Wu Y; Department of Clinical Pharmacy, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, No 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China., Shen H; Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China., Cai B; Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China., Chen C; Department of Clinical Pharmacy, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, No 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China., Yin Q; Department of Clinical Pharmacy, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, No 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China., Zhao Y; Department of Clinical Pharmacy, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, No 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China., Zhou G; Department of Clinical Pharmacy, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, No 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China. Electronic address: ghzhou@nju.edu.cn. |
| المصدر: | Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2024 Jun; Vol. 33 (6), pp. 107684. Date of Electronic Publication: 2024 Mar 20. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Saunders Country of Publication: United States NLM ID: 9111633 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8511 (Electronic) Linking ISSN: 10523057 NLM ISO Abbreviation: J Stroke Cerebrovasc Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Philadelphia, PA : Saunders Original Publication: New York, NY : Demos Publications, [1991- |
| مواضيع طبية MeSH: | Clopidogrel*/therapeutic use , Clopidogrel*/adverse effects , Platelet Aggregation Inhibitors*/adverse effects , Platelet Aggregation Inhibitors*/therapeutic use , Drug Resistance* , Cytochrome P-450 CYP2C19*/genetics , Cytochrome P-450 CYP2C19*/metabolism , Platelet Aggregation*/drug effects, Humans ; Female ; Retrospective Studies ; Male ; Aged ; Middle Aged ; Risk Factors ; Treatment Outcome ; Pharmacogenomic Variants ; Time Factors ; Platelet Function Tests ; Risk Assessment ; Sex Factors ; Brain Ischemia/drug therapy ; Brain Ischemia/diagnosis ; Recurrence ; Ischemic Stroke/drug therapy ; Ischemic Stroke/diagnosis |
| مستخلص: | Objective: Clopidogrel resistance may lead to the recurrence of cerebrovascular diseases. We aimed to identify potential factors associated with clopidogrel resistance and evaluate the clinical outcomes of the patients. Materials and Methods: In this retrospective study, patients with ischemic cerebrovascular disease treated with clopidogrel were included and classified into 2 groups according to the adenosine diphosphate (ADP)-induced platelet aggregation. Patients with the ADP inhibition rate of <30 % were included in clopidogrel resistance group, otherwise were included in clopidogrel sensitive group. CYP2C19 genotype and other clinical data were analyzed to identify factors and clinical features in the multivariate analysis. The outcomes were vascular events in 6 months. Results: In total, 139 patients were enrolled with 81 (58.27 %) in clopidogrel sensitive group and 58 (41.73 %) in clopidogrel resistance group. Female and CYP2C19 *2*3 carrying were risk factors for clopidogrel resistance, and female was an independent risk factor (OR 2.481, 95 % CI 1.066-5.771, P=0.035). The clopidogrel resistance group showed a higher use rate of argatroban (P=0.030) and a lower arachidonic acid-induced inhibition of platelet aggregation (P=0.036). Clopidogrel resistance was related to the progressing stroke (HR 3.521, 95 % CI 1.352-9.170, P=0.010), but had no influence on the bleeding events (P>0.05). Conclusions: The risk of clopidogrel resistance increased significantly in female patients. Patients with clopidogrel resistance may have an increased incidence of stroke progression in the acute phase. Competing Interests: Declaration of competing interest The authors declare that there are no competing financial interests or personal relationships that could have appeared to influence this work. (Copyright © 2024. Published by Elsevier Inc.) |
| فهرسة مساهمة: | Keywords: CYP2C19; Clopidogrel resistance; Ischemic cerebrovascular disease; Risk factor; Stroke |
| المشرفين على المادة: | A74586SNO7 (Clopidogrel) 0 (Platelet Aggregation Inhibitors) EC 1.14.14.1 (Cytochrome P-450 CYP2C19) EC 1.14.14.1 (CYP2C19 protein, human) |
| تواريخ الأحداث: | Date Created: 20240322 Date Completed: 20240510 Latest Revision: 20240510 |
| رمز التحديث: | 20240511 |
| DOI: | 10.1016/j.jstrokecerebrovasdis.2024.107684 |
| PMID: | 38518890 |
| قاعدة البيانات: | MEDLINE |
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