| Inhibitory Interaction Between Calcium Channel Blocker and Clopidogrel. | |
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MedLine Citation:
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PMID: 21857144 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background: The clinical effect of, and additive measures to overcome the possible inhibitory calcium channel blocker (CCB)-clopidogrel interaction in Asian patients undergoing percutaneous coronary intervention is unknown. Methods and Results: A total of 900 Korean patients enrolled for the multicenter, prospective, randomized Influence of CILostazol-based triple antiplatelet therapy ON ischemic complication after drug-eluting stenT implantation (CILON-T) trial were divided into 4 groups depending on CCB prescription and type of anti-platelet therapy (dual [DAT] vs. triple [TAT; addition of cilostazol to DAT]) in a 2×2 factorial manner. The primary endpoint was a composite of cardiac death, non-fatal myocardial infarction and ischemic stroke at 6 months after PCI. On-treatment platelet reactivity (OPR) was assessed on VerifyNow P2Y12 assay. Concomitant CCB use increased OPR in the DAT group (mean±SEM: 251.2±7.6 vs. 225.6±5.1; P=0.008), but not in the TAT group (214.5±9.1 vs. 203.4±5.6; P=0.294). Primary endpoint increased by use of CCB in patients with DAT (4.9% vs. 0.9%, P=0.016), but not in those with TAT (0% vs. 1.8%, P=0.346). Addition of cilostazol to DAT reduced OPR and clinical events in patients taking CCB (P=0.007 for P2Y12 reaction units; P=0.027 for thrombotic events). CCB without concomitant cilostazol use was a significant predictor of total thrombotic events. Conclusions: Concomitant use of CCB may weaken the anti-platelet effect of clopidogrel and increase subsequent thrombotic events in Asian subjects. This hazardous CCB-clopidogrel interaction may be overcome by addition of cilostazol. |
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Authors:
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Seung-Pyo Lee; Jang-Whan Bae; Kyung Woo Park; Seung-Woon Rha; Jang-Ho Bae; Jung-Won Suh; In-Ho Chae; Myeong-Chan Cho; Hyo-Soo Kim |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-8-20 |
Journal Detail:
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Title: Circulation journal : official journal of the Japanese Circulation Society Volume: - ISSN: 1347-4820 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-8-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101137683 Medline TA: Circ J Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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