The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.
Impact of Cytochrome P450 2C19 Loss-of-Function Polymorphism and of Major Demographic Characteristics on Residual Platelet Function After Loading and Maintenance Treatment With Clopidogrel in Patients Undergoing Elective Coronary Stent Placement
Open accessAbstract
OBJECTIVES The aim of this study was to evaluate the relative impact of demographic and clinical variables versus the cytochrome P450 2C19 (CYP2C19) polymorphism on antiplatelet effects of clopidogrel. BACKGROUND Platelet responses to clopidogrel show a marked interindividual variability with substantial impact on clinical outcome. Several demographic and clinical characteristics as well as a polymorphism of CYP2C19 have been described as predictors for a low response to clopidogrel. METHODS This analysis enrolled 760 patients undergoing elective coronary stent implantation after loading with 600 mg of clopidogrel. Residual platelet aggregation was determined by optical aggregometry (adenosine diphosphate 5 micromol/l) before discharge. We analyzed the predictive value of the CYP2C19*2 polymorphism and baseline variables for an insufficient antiplatelet response by multivariable regression analysis and classification and regression trees analysis and determined the proportion responsible for the antiplatelet response of these predictors by multivariable linear regression analysis. RESULTS Major independent predictors for an insufficient antiplatelet response to clopidogrel were CYP2C19*2 carrier status (odds ratio [OR]: 2.74; 95% confidence interval [CI]: 1.93 to 3.90) together with age (OR: 1.03; 95% CI: 1.01 to 1.05), diabetes mellitus (OR: 1.75; 95% CI: 1.19 to 2.56), and body mass index (OR: 1.06; 95% CI: 1.02 to 1.11). The classification and regression trees analysis demonstrated that CYP2C19*2 carrier status followed by diabetes mellitus was the best discriminator between a sufficient and an insufficient antiplatelet response to clopidogrel. The full linear regression model including all these parameters could only explain 11.5% of the antiplatelet response (5.2% by CYP2C19*2 carrier status alone). CONCLUSIONS Thus, our study does not suggest that, in patients critically dependent on adequate platelet inhibition, genotyping alone or in combination with clinical factors can replace phenotyping of platelet function. (Effect of Clopidogrel Loading and Risk of PCI [EXCELSIOR]; NCT00457236).
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Cytochrome P-450 Polymorphisms and Response to Clopidogrel
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Self-citationA Clinical Trial Comparing Three Antithrombotic-Drug Regimens after Coronary-Artery Stenting
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Genetic Determinants of Response to Clopidogrel and Cardiovascular Events
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Identification and Biological Activity of the Active Metabolite of Clopidogrel
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Cited by
Price, M. J. (2011) · JAMA · doi:10.1001/jama.2011.290 · Cited by 1,308
Scott, S. A., Sangkuhl, K., Stein, C. M., Hulot, J.-S., Mega, J. L., Roden, D. M., Klein, T. E., Sabatine, M. S., Johnson, J. A., & Shuldiner, A. R. (2013) · Clinical Pharmacology & Therapeutics · doi:10.1038/clpt.2013.105 · Cited by 962
Writing Committee Members, Abraham, N. S., Hlatky, M. A., Antman, E. M., Bhatt, D. L., Bjorkman, D. J., Clark, C. B., Furberg, C. D., Johnson, D. A., Kahi, C. J., et al. (2010) · Circulation · doi:10.1161/cir.0b013e318202f701 · Cited by 451
Valgimigli, M., Bueno, H., Byrne, R. A., Collet, J.-P., Costa, F., Jeppsson, A., Jüni, P., Kastrati, A., Kolh, P., Mauri, L., et al. (2018) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezx334 · Cited by 409
Self-citationAngiolillo, D. J., Jakubowski, J. A., Ferreiro, J. L., Tello-Montoliu, A., Rollini, F., Franchi, F., Ueno, M., Darlington, A., Desai, B., Moser, B. A., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.06.1170 · Cited by 182
Metadata
- Authors
- Hochholzer, W., Trenk, D., Fromm, M. F., Valina, C. M., Stratz, C., Bestehorn, H.-P., Büttner, H. J., & Neumann, F.-J.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2010-06
- Volume
- 55
- Issue
- 22
- Pages
- 2427-2434
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2090989590
- Cited by
- 320
- References
- 31
- FWCI
- 29.64
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Hochholzer, W., Trenk, D., Fromm, M. F., Valina, C. M., Stratz, C., Bestehorn, H.-P., Büttner, H. J., & Neumann, F.-J. (2010). Impact of Cytochrome P450 2C19 Loss-of-Function Polymorphism and of Major Demographic Characteristics on Residual Platelet Function After Loading and Maintenance Treatment With Clopidogrel in Patients Undergoing Elective Coronary Stent Placement. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2010.02.031
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
