| The case for routine genotyping in dual-antiplatelet therapy. | |
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MedLine Citation:
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PMID: 20471193 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Over 1 million coronary stent procedures are performed annually in the U.S., with dual-antiplatelet therapy, which includes the use of both aspirin and clopidogrel, being a cornerstone in the management of these patients after coronary intervention. Now, recent data have surfaced demonstrating altered active metabolite levels of clopidogrel in patients harboring hepatic cytochrome gene variants. These variants, which have been validated through genome-wide association as the dominant explanation for the marked heterogeneity of clopidogrel response, are linked to a significant increase in the risk for bleeding, stent thrombosis, myocardial infarction, and death. With viable alternatives to clopidogrel now available, including higher clopidogrel maintenance and loading doses, prasugrel, and ticagrelor, clinicians can now effectively guide therapy in those with at-risk gene variants by simple genotyping. Such an individualized approach can potentially prevent tens of thousands of adverse cardiovascular events in the over 30% of those with European ancestry and over 40% of those with Asian or African ancestry who harbor these important clopidogrel gain-of-function and loss-of-function alleles. |
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Authors:
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Samir B Damani; Eric J Topol |
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Publication Detail:
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Type: Journal Article Date: 2010-05-13 |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 56 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-12 Completed Date: 2010-07-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 109-11 Citation Subset: AIM; IM |
Copyright Information:
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Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, California 92037, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Coronary Disease
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therapy Cytochrome P-450 Enzyme System / genetics* Genotype Humans Platelet Aggregation Inhibitors / administration & dosage* Ticlopidine / administration & dosage, analogs & derivatives* |
| Chemical | |
Reg. No./Substance:
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0/Platelet Aggregation Inhibitors; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel; 9035-51-2/Cytochrome P-450 Enzyme System |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2010 Jul 6;56(2):112-6
[PMID:
20471192
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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