CYP2C19 Loss-of-Function Alleles and the Use of Omeprazole or Esomeprazole increase the Risk of Cardiovascular Outcomes in Patients Using Clopidogrel - A Real -World Study
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Pacienti, kuriem ir CYP2C19 funkcijas zuduma alēlēs vai kuri lieto CYP2C19 inhibitorus omeprazolu vai esomeprazolu, nevar pilnībā bioaktivēt klopidogrelu, un tāpēc viņiem trūkst optimālas trombozes profilakses. Klopidogrels ir bieži lietots antiagregants, ko lieto kombinācijā ar aspirīnu pacientiem, kuriem ir veikta perkutāna koronārā iejaukšanās (PCI) ar stentēšanu, lai novērstu trombu veidošanos stentā. Mūsu mērķis bija reālās dzīves potenciālo pacientu grupā izpētīt, kā CYP2C19 funkcijas zuduma alēlēs un omeprazols vai esomeprazols ietekmē kardiovaskulāru notikumu (kardiovaskulāru nāves gadījumu, atkārtotu infarktu un insultu) sastopamību pacientiem, kuri lieto klopidogrelu.
Patients carrying loss-of-function (LOF) variants of CYP2C19 or using the CYP2C19-inhibitors omeprazole or esomeprazole cannot fully bioactivate clopidogrel, and thus are lacking optimal thrombosis prevention. Clopidogrel is a frequently used antiaggregant used in combination with aspirin in patients who have underwent percutaneous coronary intervention (PCI) with stenting, to prevent in-stent thrombus formation. Our aim was to investigate in a real-life prospective patient cohort how LOF CYP2C19 variants and omeprazole or esomeprazole influence the incidence of cardiovascular events (cardiovascular deaths, reinfarction and strokes) in patients using clopidogrel.
Patients carrying loss-of-function (LOF) variants of CYP2C19 or using the CYP2C19-inhibitors omeprazole or esomeprazole cannot fully bioactivate clopidogrel, and thus are lacking optimal thrombosis prevention. Clopidogrel is a frequently used antiaggregant used in combination with aspirin in patients who have underwent percutaneous coronary intervention (PCI) with stenting, to prevent in-stent thrombus formation. Our aim was to investigate in a real-life prospective patient cohort how LOF CYP2C19 variants and omeprazole or esomeprazole influence the incidence of cardiovascular events (cardiovascular deaths, reinfarction and strokes) in patients using clopidogrel.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
klopidogrels, farmakoģenētika, reālās dzīves kohortas, koronāra sirds slimība, clopidogrel, pharmagogenetics, real-life cohorts, CAD