Risk of stroke in CYP2C19 LoF polymorphism carrier coronary artery disease patients undergoing clopidogrel therapy: An ethnicity-based updated meta-analysis

Jafrin, Sarah; Naznin, Nura Ershad; Reza, Md. Sharif; Aziz, Abdul; Islam, Mohammad Safiqul

doi:10.1016/j.ejim.2021.05.022

Cited by 12 publications

(11 citation statements)

References 93 publications

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“…The effects of CYP2C19 genetic variants on widely used antiplatelets, for example, clopidogrel in either CAD or stroke patients has been well-established including in Thai patients. The findings of these studies suggest that due to the high risk of major adverse cardiovascular events (MACE) such as death, recurrent MI, stroke, and stent thrombosis for patients carrying CYP2C19 loss-of-function (LoF) alleles, alternative antiplatelets such as prasugrel or ticagrelor not affected by the CYP2C19 genetic variants should be prescribed in order to reduce the risk of MACE (Sukasem et al, 2013;Biswas et al, 2020a;Biswas et al, 2022;Biswas and Kali, 2021b;Jafrin et al, 2021). The CPIC dosing guidelines already provided clinical recommendations for clopidogrel in acute coronary syndrome (ACS) patients with CYP2C19*2, *3, *17 variants (Scott et al, 2013).…”

Section: Antiplateletsmentioning

confidence: 99%

Pharmacogenetics and Precision Medicine Approaches for the Improvement of COVID-19 Therapies

et al. 2022

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Many drugs are being administered to tackle coronavirus disease 2019 (COVID-19) pandemic situations without establishing clinical effectiveness or tailoring safety. A repurposing strategy might be more effective and successful if pharmacogenetic interventions are being considered in future clinical studies/trials. Although it is very unlikely that there are almost no pharmacogenetic data for COVID-19 drugs, however, from inferring the pharmacokinetic (PK)/pharmacodynamic(PD) properties and some pharmacogenetic evidence in other diseases/clinical conditions, it is highly likely that pharmacogenetic associations are also feasible in at least some COVID-19 drugs. We strongly mandate to undertake a pharmacogenetic assessment for at least these drug–gene pairs (atazanavir–UGT1A1, ABCB1, SLCO1B1, APOA5; efavirenz–CYP2B6; nevirapine–HLA, CYP2B6, ABCB1; lopinavir–SLCO1B3, ABCC2; ribavirin–SLC28A2; tocilizumab–FCGR3A; ivermectin–ABCB1; oseltamivir–CES1, ABCB1; clopidogrel–CYP2C19, ABCB1, warfarin–CYP2C9, VKORC1; non-steroidal anti-inflammatory drugs (NSAIDs)–CYP2C9) in COVID-19 patients for advancing precision medicine. Molecular docking and computational studies are promising to achieve new therapeutics against SARS-CoV-2 infection. The current situation in the discovery of anti-SARS-CoV-2 agents at four important targets from in silico studies has been described and summarized in this review. Although natural occurring compounds from different herbs against SARS-CoV-2 infection are favorable, however, accurate experimental investigation of these compounds is warranted to provide insightful information. Moreover, clinical considerations of drug–drug interactions (DDIs) and drug–herb interactions (DHIs) of the existing repurposed drugs along with pharmacogenetic (e.g., efavirenz and CYP2B6) and herbogenetic (e.g., andrographolide and CYP2C9) interventions, collectively called multifactorial drug–gene interactions (DGIs), may further accelerate the development of precision COVID-19 therapies in the real-world clinical settings.

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Section: Antiplateletsmentioning

confidence: 99%

Pharmacogenetics and Precision Medicine Approaches for the Improvement of COVID-19 Therapies

et al. 2022

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“…Compared to aspirin alone, DAPT may be efficacious in acute minor stroke or transient ischemic attacks [ 126 ], established cardiovascular disease [ 127 ], and in patients with diabetes mellitus [ 128 ], at the cost of increased bleeding rates. It should be noted, however, that in the presence of a CYP2C19 loss-of-function allele, patients treated with clopidogrel for stable coronary artery disease or after percutaneous revascularization for an acute coronary syndrome may be facing an increased risk of major adverse cardiovascular events [ 129 , 130 , 131 ]. P2Y 12 gene polymorphisms might also increase the incidence of atherosclerotic events in patients treated with clopidogrel [ 132 ].…”

Section: Therapeutic Approachesmentioning

confidence: 99%

Factors Associated with Platelet Activation-Recent Pharmaceutical Approaches

Theofilis

Sagris

Oikonomou

et al. 2022

IJMS

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Platelets are at the forefront of human health and disease following the advances in their research presented in past decades. Platelet activation, their most crucial function, although beneficial in the case of vascular injury, may represent the initial step for thrombotic complications characterizing various pathologic states, primarily atherosclerotic cardiovascular diseases. In this review, we initially summarize the structural and functional characteristics of platelets. Next, we focus on the process of platelet activation and its associated factors, indicating the potential molecular mechanisms involving inflammation, endothelial dysfunction, and miRs. Finally, an overview of the available antiplatelet agents is being portrayed, together with agents possessing off-set platelet-inhibitory actions, while an extensive presentation of drugs under investigation is being given.

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Section: Introductionmentioning

confidence: 99%

“…Clopidogrel is one of the most widely used antiplatelet drugs for the treatment of ischemic cerebrovascular disease and the secondary prevention of ischemic stroke [1][2][3]. However, approximately 16-65% of patients treated with clopidogrel show resistance due to the gene polymorphism, especially the CYP2C19 [3][4][5]. Furthermore, the majority (about 85%) of clopidogrel is hydrolyzed by carboxylesterase 1 (CES1) to inactive clopidogrel acid upon entry into the body [6,7].…”

Section: Introductionmentioning

confidence: 99%

Quantitative Determination of Four Potential Genotoxic Impurities in the Active Pharmaceutical Ingredients in TSD-1 Using UPLC-MS/MS

Wang

Yang

et al. 2022

Molecules

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A novel method of ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) was developed for the identification and quantification of four potential genotoxic impurities (PGIs) in the active pharmaceutical ingredients of TSD-1, a novel P2Y12 receptor antagonist. Four PGIs were named, 4-nitrobenzenesulfonic acid, methyl 4-nitrobenzenesulfonate, ethyl 4-nitrobenzenesulfonate, and isopropyl 4-nitrobenzenesulfonate. Following the International Conference of Harmonization (ICH) guidelines, this methodology is capable of quantifying four PGIs at 15.0 ppm in samples of 0.5 mg/mL concentration. This validated approach presented very low limits (0.1512–0.3897 ng/mL), excellent linearity (coefficients > 0.9900), and a satisfactory recovery range (94.9–115.5%). The method was sufficient in terms of sensitivity, linearity, precision, accuracy, selectivity, and robustness and, thus, has high practicality in the pharmaceutical quality control of TSD-1.

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Risk of stroke in CYP2C19 LoF polymorphism carrier coronary artery disease patients undergoing clopidogrel therapy: An ethnicity-based updated meta-analysis

Cited by 12 publications

References 93 publications

Pharmacogenetics and Precision Medicine Approaches for the Improvement of COVID-19 Therapies

Pharmacogenetics and Precision Medicine Approaches for the Improvement of COVID-19 Therapies

Factors Associated with Platelet Activation-Recent Pharmaceutical Approaches

Quantitative Determination of Four Potential Genotoxic Impurities in the Active Pharmaceutical Ingredients in TSD-1 Using UPLC-MS/MS

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