Comparison Between Clopidogrel and Prasugrel Associated With CYP2C19 Genotypes in Patients Receiving Percutaneous Coronary Intervention in a Japanese Population

• Sawayama Yuichi

  Department of Cardiovascular Medicine, Shiga University of Medical Science

• Yamamoto Takashi

  Department of Cardiovascular Medicine, Shiga University of Medical Science

• Tomita Yukinori

  Department of Cardiovascular Medicine, Toyosato Hospital

• Asada Kohei

  Department of Cardiovascular Medicine, Shiga University of Medical Science

• Yagi Noriaki

  Department of Cardiovascular Medicine, Shiga University of Medical Science

• Fukuyama Megumi

  Department of Cardiovascular Medicine, Shiga University of Medical Science

• Miyamoto Akashi

  Department of Cardiovascular Medicine, Shiga University of Medical Science

• Sakai Hiroshi

  Department of Cardiovascular Medicine, Shiga University of Medical Science

• Ozawa Tomoya

  Department of Cardiovascular Medicine, Shiga University of Medical Science

• Isono Tetsuichiro

  Department of Pharmacy, Shiga University of Medical Science

• Hira Daiki

  Department of Pharmacy, Shiga University of Medical Science College of Pharmaceutical Sciences, Ritsumeikan University

• Terada Tomohiro

  Department of Pharmacy, Shiga University of Medical Science

• Horie Minoru

  Center for Epidemiologic Research in Asia, Shiga University of Medical Science

• Nakagawa Yoshihisa

  Department of Cardiovascular Medicine, Shiga University of Medical Science

書誌事項

タイトル別名

• Comparison Between Clopidogrel and Prasugrel Associated With <i>CYP2C19</i> Genotypes in Patients Receiving Percutaneous Coronary Intervention in a Japanese Population

抄録

Background:The association between cytochrome P450 (CYP) 2C19 genotypes and adverse events in patients treated with clopidogrel or prasugrel after percutaneous coronary intervention (PCI) in the Japanese population is unclear. Methods and Results:This study consisted of 1,580 patients whoseCYP2C19genotypes were assessed at Shiga University of Medical Science Hospital, and 193 clopidogrel-treated and 217 prasugrel-treated patients who were followed more than 1 year after receiving PCI were analyzed. Among 1,580 patients, the prevalence of normal, intermediate, and poor metabolizers was 32%, 49%, and 17%, respectively. Overall incidence of the primary outcome, defined as a composite of cardiovascular death, myocardial infarction, definite stent thrombosis, ischemic stroke, or major bleeding was not significantly different between the clopidogrel and prasugrel groups (adjusted hazard ratio [HR] 1.98, 95% confidence interval [CI] 0.85–4.61, P=0.12). Among patients with theCYP2C19loss-of-function (LOF) allele, however, the incidence of the primary outcome was significantly higher in the clopidogrel group (adjusted HR 3.19, 95% CI 1.10–9.24, P=0.03), whereas no difference was observed among patients without theCYP2C19LOF allele (adjusted HR 0.67, 95% CI 0.14–3.26, P=0.62). Conclusions:Among patients with theCYP2C19LOF allele, the use of clopidogrel was significantly associated with increased adverse events. Thus, further investigation is needed to establish the practical use ofCYP2C19genotyping.

収録刊行物

• Circulation Journal

  Circulation Journal 84 (9), 1575-1581, 2020-08-25

  一般社団法人 日本循環器学会

キーワード

• Clopidogrel
• <i>CYP2C19</i>
• Percutaneous coronary intervention
• Prasugrel
• P2Y12 inhibitor

詳細情報

• CRID: 1390285300184322944
• NII論文ID: 130007890783
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-20-0254
• ISSN: 13474820
• ISSN: 13469843
• NDL書誌ID: 030597123
• PubMed: 32713878
• Web Site: http://id.ndl.go.jp/bib/030597123
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I030597123
• Web Site: https://www.jstage.jst.go.jp/article/circj/84/9/84_CJ-20-0254/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2021124159
• 本文言語コード: en
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• 抄録ライセンスフラグ: 使用不可