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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
10
pubmed:dateCreated
2009-5-11
pubmed:abstractText
Small studies have indicated that drug-drug interactions and such clinical characteristics as diabetes mellitus may increase residual platelet reactivity in patients on clopidogrel therapy. The independent contribution of these variables to high residual platelet reactivity (HRPR) is not well studied. Residual platelet reactivity was assessed using the VerifyNow P2Y12 assay (Accumetrics Inc., San Diego, California) in 377 patients with stable coronary artery disease on maintenance clopidogrel therapy. HRPR was defined using a threshold previously shown to predict adverse clinical outcomes. Residual platelet reactivity was significantly higher in women (220 +/- 82 vs 200 +/- 77 P2Y12 reaction units [PRU]; p = 0.041), non-Caucasians (229 +/- 79 vs 202 +/- 78 PRU; p = 0.047), patients with diabetes mellitus (220 +/- 73 vs 196 +/- 80 PRU; p = 0.005), and those treated with nitrates (233 +/- 70 vs 200 +/- 80 PRU; p = 0.018) or proton-pump inhibitors (218 +/- 79 vs 198 +/- 78 PRU; p = 0.02), whereas residual platelet reactivity was significantly lower in active smokers (168 +/- 82 vs 208 +/- 77 PRU; p = 0.006). Independent predictors of HRPR were female gender (odds ratio [OR] 1.91, 95% confidence interval [CI] 1.14 to 3.19, p = 0.014), non-Caucasian ethnicity (OR 3.05, 95% CI 1.49 to 6.28, p = 0.002), use of proton-pump inhibitors (OR 1.64, 95% CI 1.03 to 2.59, p = 0.035), and active smoking (OR 0.37, 95% CI 0.14 to 0.94, p = 0.037). HRPR was associated with increased 6-month mortality rates (3.0% vs 0%; p = 0.016). In conclusion, our findings support the hypothesis that clopidogrel nonresponsiveness is primarily the result of genetic mechanisms and factors that may influence activity of the cytochrome P-450 system.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
May
pubmed:issn
1879-1913
pubmed:author
pubmed:issnType
Electronic
pubmed:day
15
pubmed:volume
103
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1339-43
pubmed:meshHeading
pubmed-meshheading:19427425-Aged, pubmed-meshheading:19427425-Blood Platelets, pubmed-meshheading:19427425-Chi-Square Distribution, pubmed-meshheading:19427425-Coronary Disease, pubmed-meshheading:19427425-Drug Interactions, pubmed-meshheading:19427425-Drug-Eluting Stents, pubmed-meshheading:19427425-Female, pubmed-meshheading:19427425-Humans, pubmed-meshheading:19427425-Logistic Models, pubmed-meshheading:19427425-Male, pubmed-meshheading:19427425-Middle Aged, pubmed-meshheading:19427425-Platelet Aggregation, pubmed-meshheading:19427425-Platelet Aggregation Inhibitors, pubmed-meshheading:19427425-Platelet Function Tests, pubmed-meshheading:19427425-Predictive Value of Tests, pubmed-meshheading:19427425-Sirolimus, pubmed-meshheading:19427425-Ticlopidine, pubmed-meshheading:19427425-Treatment Outcome
pubmed:year
2009
pubmed:articleTitle
Predictors of heightened platelet reactivity despite dual-antiplatelet therapy in patients undergoing percutaneous coronary intervention.
pubmed:affiliation
Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, California, USA. price.matthew@scrippshealth.org
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't