지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2011.1
- 수록면
- 91 - 94 (4page)
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초록· 키워드
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Background: Clopidogrel has been widely used to prevent recurrent ischemia in patients with acute coronary syndrome (ACS). However, inter-individual variability in response to clopidogrel has been a problem in the clinical setting. The aim of the present study was to investigate the frequency of clopidogrel resistance and to determine the clinical, pharmacokinetic, and pharmacogenetic factors for clopidogrel resistance in Korean patients with ACS.
Methods: Clinical information, such as the underlying diseases and concurrent medications, of 114 patients with ACS who received clopidogrel therapy was studied. The degree of inhibition of platelets was assessed using the VerifyNow assay (Accumetrics, USA). The patients who showed less than 20% inhibition of platelets were defined as non-responders to clopidogrel treatment. Steady state plasma concentrations of clopidogrel were measured using HPLC/tandem mass spectrometry. CYP2C19 genotyping was also performed.
Results: A wide inter-individual variability was observed in platelet inhibition (0–76%); 56 patients (49%) showed less than 20% inhibition. There were no differences between the patients’ history of diabetes mellitus and concurrent medications as well as the plasma concentrations of clopidogrel of the responders and non-responders. CYP2C19 variants, including CYP2C19*2 and CYP2C19*3, were more commonly observed in the non-responders than in the responders (P value<0.0001).
Conclusions: The response to clopidogrel was highly variable in Korean patients with ACS. The results of the present study confirm-ed that the genetic polymorphism of CYP2C19 could be important in clopidogrel response. However, further studies are required to investigate other likely factors involved in clopidogrel resistance.
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참고문헌 (14)
참고문헌 신청
Angiolillo DJ / 2005 / Identification of low responders to a 300-mg clopidogrel loading dose in patients undergoing coronary stenting / Thromb Res 115 : 101 ~ 108
Angiolillo DJ / 2007 / Platelet function testing and cardiovascular outcomes: steps forward in identifying the best predictive measure / Thromb Haemost 98 : 707 ~ 709
Bonello L / 2008 / Adjusted clopidogrel loading doses according to vasodilator-stimulated phosphoprotein phosphorylation index decrease rate of major adverse cardiovascular e
Bouman HJ / 2010 / Which platelet function test is suitable to monitor clopidogrel responsiveness? A pharmacokinetic analysis on the active metabolite of clopidogrel / J Thr
Collet JP / 2009 / Cytochrome P450 2C19 polymorphism in young patients treated with clopidogrel after myocardial infarction: a cohort study / Lancet 373 : 309 ~ 317
Angiolillo DJ / 2007 / Platelet function testing and cardiovascular outcomes: steps forward in identifying the best predictive measure / Thromb Haemost 98 : 707 ~ 709
Bonello L / 2008 / Adjusted clopidogrel loading doses according to vasodilator-stimulated phosphoprotein phosphorylation index decrease rate of major adverse cardiovascular e
Bouman HJ / 2010 / Which platelet function test is suitable to monitor clopidogrel responsiveness? A pharmacokinetic analysis on the active metabolite of clopidogrel / J Thr
Collet JP / 2009 / Cytochrome P450 2C19 polymorphism in young patients treated with clopidogrel after myocardial infarction: a cohort study / Lancet 373 : 309 ~ 317
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