Linked Life Data

19504052

Source:http://linkedlifedata.com/resource/pubmed/id/19504052

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
2009-10-23
pubmed:abstractText
Antiplatelet therapy with clopidogrel has been shown to reduce major adverse cardiac events in acute coronary syndromes and after percutaneous interventions. This effect is not only due to its anti-platelet effect but also possibly due to an anti-inflammatory effect. The effect of clopidogrel cessation after one year of therapy on markers of inflammation has been investigated in diabetics and showed an increase in platelet aggregation as well as hsCRP and surface P-selectin levels. This was an exploratory multicenter prospective open-label single arm study of 98 non-diabetic patients who had received one or more drug eluting stents and were coming to the end of their 12 months course of clopidogrel therapy. The effect of clopidogrel cessation on expression of biomarkers: sCD40L, soluble P-selectin and hsCRP was measured right before clopidogrel cessation (day 0), and subsequently at 1, 2, 3 and 4 weeks after drug withdrawal. A median increase in sCD40L expression from 224 to 324.5 pg/ml was observed between baseline and 4 weeks after clopidogrel cessation, which corresponded to a 39% mean percent change based on an ANCOVA model (P < 0.001). Over the 4 weeks observation period the change in sCD40L expression correlated weakly with soluble P-selectin levels (at 4 weeks Spearman's correlation coefficient = 0.32; P = 0.0024). Increase in P-selectin expression from baseline was statistically significant at week 1 and 2. Conversely, hsCRP level decreased by 21% at 1 week (P = 0.008) and was still reduced by 18% by 4 weeks (P = 0.062). The change in sCD40L expression appeared to vary with the type of drug eluting stent. Patients treated with drug eluting stents at 1 year after implantation display significant increase in sCD40L and decrease in hsCRP after clopidogrel cessation. Further studies should elucidate if this increase in sCD40L levels reflects solely the removal of the inhibitory effects of clopidogrel on platelet activity or rather an increase in pro-inflammatory state. The latter hypothesis may be less likely given decrease in hsCRP levels. Randomized studies are urgently needed to establish potential link of clopidogrel discontinuation and vascular outcomes.
pubmed:commentsCorrections
http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-12390961, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-12435254, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-12615789, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-12646667, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-15172401, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-15276105, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-15585987, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-15670038, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-15870416, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-16286165, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-16442361, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-16442924, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-16505243, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-16806409, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-17053008, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-17161243, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-1717069, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-17291930, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-17325255, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-17510464, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-17615799, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-17869634, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-17950831, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-18252883, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-18312754, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-18549844, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-18997196, http://linkedlifedata.com/resource/pubmed/commentcorrection/19504052-19038679
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
1573-742X
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
28
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
410-7
pubmed:dateRevised
2010-9-24
pubmed:meshHeading
pubmed:year
2009
pubmed:articleTitle
Effect of clopidogrel discontinuation at 1 year after drug eluting stent placement on soluble CD40L, P-selectin and C-reactive protein levels: DECADES (Discontinuation Effect of Clopidogrel After Drug Eluting Stent): a multicenter, open-label study.
pubmed:affiliation
Interventional Cardiology, Thoraxcenter, Erasmus MC, University Medical Center, 's Gravendijkwal 230, 3015CE, Rotterdam, The Netherlands.
pubmed:publicationType
Journal Article, Clinical Trial, Comparative Study, Multicenter Study