Characterization of Patients With Angioscopically-Detected In-Stent Mural Thrombi : Genetics of Clopidogrel Responsiveness and Generations of Drug-Eluting Stents
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- Ichikawa Minoru
- Department of Cardiology, Higashi-osaka City General Hospital
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- Takei Yoshizumi
- Department of Cardiology, Higashi-osaka City General Hospital
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- Hamasaki Toshimitsu
- Department of Biomedical Statistics, Osaka University Graduate School of Medicine
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- Kijima Yoshiyuki
- Department of Cardiology, Higashi-osaka City General Hospital
書誌事項
- タイトル別名
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- Characterization of Patients With Angioscopically-Detected In-Stent Mural Thrombi
- – Genetics of Clopidogrel Responsiveness and Generations of Drug-Eluting Stents –
この論文をさがす
抄録
Background:The loss-of-function genotype of cytochrome P450 2C19 (CYP2C19) has been proposed as a risk factor for stent thrombosis in patients with drug-eluting stent implantation. The aim of this study was to clarify the clinical features of patients with angioscopically-detected in-stent mural thrombi (ISMT).Methods and Results:Enrolled were 100 stented segments in 55 patients with stable angina (20 bare-metal stents; 39 Cypher sirolimus-eluting stents [SES]; 26 Endeavor zotarolimus-eluting stents [ZES]; 13 Xience V everolimus-eluting stents; and 2 Nobori biolimus-eluting stents). Dual antiplatelet therapy (100 mg aspirin+75 mg clopidogrel once daily) had been continued since stenting. A poor metabolizer (PM) of clopidogrel was defined as a homozygote of CYP2C19 loss-of-function alleles. Coronary angioscopy revealed ISMT in 6 patients (5 SES, 1 ZES). Between the ISMT group and control group (n=49), there were no significant differences with regards to the VerifyNow P2Y12platelet function assay or in-stent endothelial coverage grade. Exact logistic regression analyses with stepwise forward selection at a significance level of 0.10 were performed to reveal predictive variables for ISMT (respectively: odds ratio, 95% confidence interval, P value: CYP2C19 PM genotype (3.28, 0.88–24.80, 0.09), SES implantation (3.37, 0.90–28.09, 0.08), and presence of yellow plaque (3.69, 1.14–25.70, 0.02).Conclusions:Patients with ISMT were characterized by SES implantation, poor clopidogrel metabolism, and in-stent yellow plaque. (Circ J 2015; 79: 85–90)
収録刊行物
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- Circulation Journal
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Circulation Journal 79 (1), 85-90, 2014
一般社団法人 日本循環器学会
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詳細情報 詳細情報について
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- CRID
- 1390282680083622784
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- NII論文ID
- 130004701551
- 40020311798
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- NII書誌ID
- AA11591968
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- ISSN
- 13474820
- 13469843
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- NDL書誌ID
- 026000836
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- PubMed
- 25744629
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可