在接受皮肤冠状动脉干预的CYP2C19中间代谢剂中,基因型导向的处方预测因子
Joshua J Park1, Gervacio Y Cabel1, Kevin K Cheng1
1University of Illinois Chicago College of Pharmacy, Chicago, IL 60612, USA.
Pharmacogenomics
|June 17, 2024
概括
在CYP2C19中间代谢剂中,基因型导向的抗血小板治疗没有增加主要不良心血管事件或出血. 然而,抗凝剂的使用与克洛皮多格勒的处方有关,而不是最佳治疗选择.
科学领域:
- 药物基因组学 药物基因组学
- 心血管医学 心血管医学
- 临床药房 临床药房
背景情况:
- 对CYP2C19中间代谢剂的指导方针差异可能会阻碍经皮肤冠状动脉干预后的基因型导向抗血小板治疗.
- 之前的研究强调了基于遗传特征的处方实践的潜在局限性.
研究的目的:
- 评估基因型导向 (PGx) -最佳抗血小板治疗对CYP2C19中间代谢物的影响.
- 确定与PGx最佳治疗选择和临床结果相关的因素.
主要方法:
- 单中心回顾性观察性队列研究.
- 对接受皮肤冠状动脉干预的CYP2C19中间代谢器状态的患者的分析.
- 在PGx-最佳和PGx-亚最佳治疗组之间的结果比较.
主要成果:
- 接受PGx最佳治疗的患者更年轻,不太可能服用抗凝药 (2%对12%,p=0.006).
- 商业保险是PGx最佳治疗选择的重要预测因素 (OR:6.464,p<0.001).
- 抗凝药的使用与克洛皮多格雷尔的使用有关 (OR:0.138,p=0.020).
结论:
- 在PGx-最佳和亚最佳治疗组之间没有观察到主要不良心血管事件或出血的显著差异.
- 抗凝药的使用似乎影响了克洛皮多格雷尔的处方,而不管PGx-最佳疗法.
- 诸如保险状况等因素会影响基因型导向抗血小板治疗的选择.
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