Cardiovascular risk in clopidogrel-treated patients according to cytochrome P450 2C19*2 loss-of-function allele or proton pump inhibitor coadministration: a systematic meta-analysis

Journal of the American College of Cardiology
Jean-Sébastien HulotGilles Montalescot

Abstract

The aim of this study was to assess the association between the loss-of-function cytochrome P450 2C19 (CYP2C19)*2 variant (10 studies, 11,959 patients) or the use of proton pump inhibitors (PPIs) (13 studies, 48,674 patients) and ischemic outcomes (major adverse cardiovascular events [MACE]) in patients treated with clopidogrel. In clopidogrel-treated patients, increased cardiovascular risk has been identified with the loss-of-function CYP2C19*2 allele or the use of PPIs, some of them CYP2C19 inhibitors. To further estimate the effect of a reduction in activity of this enzyme, the authors performed a meta-analysis of the studies available. The meta-analysis was performed on 23 studies using the odds ratio (OR) as the parameter of efficacy, with a fixed-effect model. The end points were MACE, mortality, or stent thrombosis. Of the 11,959 patients, carriers of the loss-of-function CYP2C19*2 allele (28% [n = 3,418]) displayed a 30% increase in the risk for MACE compared with noncarriers (9.7% vs. 7.8%; OR: 1.29; 95% confidence interval [CI]: 1.12 to 1.49; p < 0.001). This single gene variant (CYP2C19*2) was also associated with an excess of mortality (1.8% vs. 1.0%; OR: 1.79; 95% CI: 1.10 to 2.91; p = 0.019; n = 6,225) and of sten...Continue Reading

References

Jul 1, 1997·Computer Methods and Programs in Biomedicine·M CucheratM C Haugh
Oct 6, 1997·BMJ : British Medical Journal·M EggerC Minder
Feb 6, 1998·BMJ : British Medical Journal·M Egger, G D Smith
Aug 25, 2001·The New England Journal of Medicine·S YusufUNKNOWN Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators
Mar 15, 2006·The New England Journal of Medicine·Deepak L BhattUNKNOWN CHARISMA Investigators
Apr 10, 2007·Journal of the American College of Cardiology·Dominick J AngiolilloMarco A Costa
Aug 19, 2007·Journal of Thrombosis and Haemostasis : JTH·P FontanaP Gaussem
Nov 20, 2008·Journal of the American College of Cardiology·Deepak L BhattUNKNOWN American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents
Dec 17, 2008·American Heart Journal·Jolanta M Siller-MatulaBernd Jilma
Dec 25, 2008·The New England Journal of Medicine·Tabassome SimonUNKNOWN French Registry of Acute ST-Elevation and Non-ST-Elevation Myocardial Infarction (FAST-MI) Investigators
Dec 25, 2008·The New England Journal of Medicine·Jessica L MegaMarc S Sabatine
Jan 30, 2009·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·David N JuurlinkMuhammad M Mamdani
Mar 5, 2009·JAMA : the Journal of the American Medical Association·P Michael HoJohn S Rumsfeld
Mar 10, 2009·The American Journal of Cardiology·Betti GiustiGian Franco Gensini
Apr 8, 2009·Thrombosis and Haemostasis·Dirk SibbingNicolas von Beckerath
Apr 14, 2009·Current Atherosclerosis Reports·Ali J Marian
Aug 27, 2009·JAMA : the Journal of the American Medical Association·Alan R ShuldinerPaul A Gurbel

❮ Previous
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Citations

Dec 31, 2011·Human Genetics·Thomas CuissetMarie-Christine Alessi
May 11, 2013·International Journal of Clinical Pharmacy·Melissa MejinAlan Yean Yip Fong
Jun 28, 2011·Journal of Thrombosis and Thrombolysis·Aldona KubicaAleksander Goch
Jun 29, 2011·Purinergic Signalling·Stephen O'ConnorJean-Philippe Collet
May 22, 2013·Current Cardiology Reports·Peter Weeke, Dan M Roden
Dec 21, 2011·Current Treatment Options in Cardiovascular Medicine·Mark R Thomas, Robert F Storey
Jan 15, 2013·Journal of Cardiovascular Translational Research·Thomas Cuisset, Jacques Quilici
Jan 13, 2012·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Charles M StromWeimin Sun
Sep 7, 2013·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Josh F PetersonJosh C Denny
Dec 21, 2010·Nature Medicine·Heleen J BoumanDirk Taubert
Jan 11, 2011·Nature Medicine·Eric J Topol, Nicholas J Schork
Feb 15, 2012·Nature Reviews. Gastroenterology & Hepatology·Paul Moayyedi, Grigorios I Leontiadis
Apr 12, 2012·The Pharmacogenomics Journal·S MartisS A Scott
Jan 14, 2012·Genetic Testing and Molecular Biomarkers·Claudia SaraciniBetti Giusti
Oct 25, 2011·European Heart Journal·Carlo PatronoFreek Verheugt
Nov 10, 2011·European Heart Journal·Johanne SilvainGilles Montalescot
Feb 22, 2013·European Heart Journal·Stefan AgewallUNKNOWN ESC Working Group on Cardiovascular Pharmacology and Drug Therapy and ESC Working Group on Thrombosis
Feb 2, 2012·Cardiology in Review·Sweta GoswamiJames Nawarskas
Oct 8, 2013·Cardiology in Review·Daniela I Roberts, James J Nawarskas
Mar 3, 2012·Current Opinion in Cardiology·Quinn S WellsDan M Roden
Dec 7, 2011·Journal of Gastroenterology and Hepatology·Francis K L Chan
Sep 7, 2013·Heart·Shahed Islam, Adam Timmis
May 31, 2012·Circulation·Euan A AshleyUNKNOWN American Heart Association Advocacy Coordinating Committee
Sep 17, 2011·Circulation Research·Dan M RodenRussell A Wilke
Oct 4, 2013·BMC Veterinary Research·Annika WeigandJustus P Beier
Dec 2, 2011·Circulation Journal : Official Journal of the Japanese Circulation Society·Tadasuke ChitoseUNKNOWN Kumamoto Intervention Conference Study (KICS) Investigators
Dec 18, 2013·PloS One·Sarah C PreissnerSaskia Preissner
Aug 9, 2011·Drug Metabolism and Drug Interactions·Sandra L Close
May 23, 2012·World Journal of Gastroenterology : WJG·Michael D DrepperJean Louis Frossard
Sep 27, 2013·European Heart Journal·Dániel AradiUNKNOWN Working Group on Thrombosis of the European Society of Cardiology
Sep 14, 2013·Internal and Emergency Medicine·Emilia D'UgoRaffaele De Caterina
Mar 28, 2013·Cardiology Research and Practice·Adriana Dana Oprea, Wanda M Popescu
Mar 15, 2014·Pharmacogenomics·Alfi YasminaVera H M Deneer
Nov 23, 2012·Pharmacogenomics·Betti GiustiRosanna Abbate

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