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Influence of Genetic and Epigenetic Factors of P2Y12 Receptor on the Safety and Efficacy of Antiplatelet Drugs
AbstractPurposeP2Y12 receptor inhibitors are drugs that decrease the risk of stent thrombosis and lower the long-term risk of non-stent-related myocardial infarction and stroke. They inhibit the binding of adenosine diphosphate (ADP) to the P2Y12 receptor and effectively reduce platelet reactivity. However, considerable variability in the pharmacodynamics response contributes to a failure of antiplatelet therapy; this phenomenon is especially notorious for older drugs, such as clopidogrel. Some genetic polymorphisms associated with these drugs ’ metabolic pathway, especially in the CYP2C19 gene, can significantly decreas...
Source: Cardiovascular Drugs and Therapy - August 9, 2022 Category: Cardiology Source Type: research

Association of CYP2C19 Loss-of-Function Alleles with Major Adverse Cardiovascular Events of Clopidogrel in Stable Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention: Meta-analysis
ConclusionStable CAD patients treated with clopidogrel and carriedCYP2C19 LoF alleles undergoing PCI were associated with significantly increased risk of MACE compared to non-carriers, even markedly significant for Asian patients.
Source: Cardiovascular Drugs and Therapy - December 1, 2021 Category: Cardiology Source Type: research

Rationale and Design of the H-REPLACE Study: Safety and Efficacy of LMWH Versus Rivaroxaban in ChinEse Patients HospitaLized with Acute Coronary SyndromE
ConclusionsThe H-REPLACE trial offers an opportunity to assess clinical outcomes of rivaroxaban versus enoxaparin during the acute phase of ACS and may provide an alternative anticoagulation strategy for ACS patients, who missed the primary reperfusion therapy window and before selective revascularization.Trial RegistrationClinicalTrials.gov; NCT03363035.
Source: Cardiovascular Drugs and Therapy - September 22, 2020 Category: Cardiology Source Type: research

Benefit-Risk Profile of DAPT Continuation Beyond 1  Year after PCI in Patients with High Thrombotic Risk Features as Endorsed by 2018 ESC/EACTS Myocardial Revascularization Guideline
ConclusionsAmong patients with ESC-endorsed HTR who were free from major ischemic or bleeding events 1  year after coronary stenting, continued DAPT beyond 1 year might offer better effectiveness in terms of atherothrombotic events and comparable safety in terms of clinically relevant bleeding compared with ≤ 1-year DAPT. ESC-HTR criteria is an important parameter to take into account in tailor ing DAPT prolongation.
Source: Cardiovascular Drugs and Therapy - June 28, 2020 Category: Cardiology Source Type: research

Ticagrelor Versus Clopidogrel in Patients with Late or Very Late Stent Thrombosis
ConclusionFollowing successful primary PCI, patients with LST/VLST who received ticagrelor had fewer ischemic cardiovascular events at 1-yr follow-up, compared with those who received clopidogrel.
Source: Cardiovascular Drugs and Therapy - June 21, 2020 Category: Cardiology Source Type: research

CYP2C19 LOF and GOF-Guided Antiplatelet Therapy in Patients with Acute Coronary Syndrome: A Cost-Effectiveness Analysis
ConclusionsUsing bothCYP2C19 GOF and LOF alleles to select antiplatelet therapy appears to be the preferred antiplatelet strategy over universal clopidogrel and universal alternative P2Y12 inhibitor therapy for ACS patients with PCI.
Source: Cardiovascular Drugs and Therapy - December 6, 2016 Category: Cardiology Source Type: research