Review
Biochemistry & Molecular Biology
Abdullah Alkattan, Eman Alsalameen
Summary: Genetic variants of key enzymes like CYP2C19, CYP3A4, CYP2C9, CYP2B6, and CYP1A2 are associated with the clinical efficacy and safety of clopidogrel, influencing patient response to the medication. Non-genetic factors such as age and diabetes may also play a role in determining clopidogrel responsiveness, suggesting personalized approaches to treatment may be necessary. Platelet inhibition tests can be used to predict the clinical efficacy of clopidogrel, and alternative medications like other P2Y12 receptor inhibitors should be considered when genetic factors are a concern.
EXPERT OPINION ON DRUG METABOLISM & TOXICOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Amber L. Beitelshees, Cameron D. Thomas, Philip E. Empey, George A. Stouffer, Dominick J. Angiolillo, Francesco Franchi, Sony Tuteja, Nita A. Limdi, James C. Lee, Julio D. Duarte, Rolf P. Kreutz, Todd C. Skaar, James C. Coons, Jay Giri, Caitrin W. McDonough, Rachel Rowland, James M. Stevenson, Thuy Thai, Mark R. Vesely, Jacob T. Wellen, Julie A. Johnson, Almut G. Winterstein, Larisa H. Cavallari, Craig R. Lee
Summary: The clinical implementation of CYP2C19-guided antiplatelet therapy after PCI has shown better outcomes compared to clopidogrel treatment. For patients with a CYP2C19 loss-of-function variant, alternative therapy significantly reduces the risk of major atherothrombotic events.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Review
Biochemistry & Molecular Biology
Natasa Djordjevic
Summary: This review summarizes the evidence on the association between CYP2C19 polymorphism and clopidogrel-based therapy; discusses the clinical recommendations for the use of CYP2C19 genotype testing in clopidogrel-treated patients; and explores potential pitfalls and future perspectives of antiplatelet pharmacogenetics.
EXPERT OPINION ON DRUG METABOLISM & TOXICOLOGY
(2022)
Review
Genetics & Heredity
Alfredo Mauriello, Antonia Ascrizzi, Riccardo Molinari, Luigi Falco, Alfredo Caturano, Antonello D'Andrea, Vincenzo Russo
Summary: Pharmacogenomics plays an important role in personalized medicine, especially in the field of cardiovascular drug therapy. Genotype-guided approach improves the effectiveness of antiplatelet therapy, while various genetic polymorphisms affect the efficacy of anticoagulants and statin drugs. Pharmacogenomics has the potential to guide new drug therapies for cardiovascular diseases.
Article
Clinical Neurology
Pious D. Patel, Xinnan Niu, Chevis N. Shannon, Joshua C. Denny, Josh F. Peterson, Matthew R. Fusco, Rohan V. Chitale
Summary: This study found a significant association between CYP2C19 genotype and ischemic stroke risk in asymptomatic carotid stenosis patients receiving clopidogrel, with patients carrying loss-of-function alleles facing a 2- to 10-fold increased risk. This suggests that CYP2C19 genotype may be a factor to consider when selecting antiplatelet therapy for stroke prophylaxis in non-procedural, asymptomatic carotid stenosis patients.
TRANSLATIONAL STROKE RESEARCH
(2022)
Article
Medicine, General & Internal
Renske H. Olie, Rachelle R. K. Hensgens, Petal A. H. M. Wijnen, Leo F. Veenstra, Bianca T. A. de Greef, Minka J. A. Vries, Paola E. J. van der Meijden, Jurrien M. ten Berg, Hugo ten Cate, Otto Bekers, Yvonne M. C. Henskens
Summary: The study evaluated the differential effects of the CYP2C19 genotype on three different platelet function tests, showing that the metabolizer status of CYP2C19 significantly affects on-treatment platelet reactivity as measured by LTA and VerifyNow, but not by Multiplate. This suggests that the disagreement between PFTs is partly due to the differential effects of the CYP2C19 genotype, along with other patient-related variables.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Biotechnology & Applied Microbiology
Zainab Omer Ali, Loulia Bader, Shaaban Mohammed, Salaheddin Arafa, Abdulrahman Arabi, Larisa Cavallari, Taimour Langaee, Fatima Mraiche, Nasser Rizk, Ahmed Awaisu, Mohamed H. Shahin, Hazem Elewa
Summary: The study demonstrated a significant association between the CYP2C19*17 allele and increased risk of bleeding, while CYP2C19*2 or *3 were associated with MACE outcomes.
PHARMACOGENETICS AND GENOMICS
(2022)
Article
Pharmacology & Pharmacy
Stefan Russmann, Ali Rahmany, David Niedrig, Karl-Dietrich Hatz, Katja Ludin, Andrea M. Burden, Lars Englberger, Roland Backhaus, Andreas Serra, Markus Bechir
Summary: PGx-guided clopidogrel therapy can identify patients at high risk of ischemic events, especially those with CYP2C19 loss of function (LoF) variants, and offer personalized alternative treatments to reduce the risk of recurrent events. Successful implementation in clinical practice requires a personalized interdisciplinary service that evaluates indications, risk factors, and provides specific recommendations.
EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY
(2021)
Review
Medicine, General & Internal
Xiaolan Shao, Xiuhong Cui
Summary: Antithrombotic therapy may increase the risk of bleeding-related complications and conversion to open surgery in patients undergoing cholecystectomies.
PAKISTAN JOURNAL OF MEDICAL SCIENCES
(2022)
Article
Medicine, General & Internal
Snezana Mugosa, Ivan Radosavljevic, Majda Sahman, Natasa Djordjevic, Zoran Todorovic
Summary: This study investigated the influence of various factors on clopidogrel adverse drug reactions (ADRs) in cardiology patients. The study found that CYP2C19 gene polymorphisms, co-medication, and gastrointestinal comorbidity are important factors contributing to clopidogrel ADRs.
Article
Pharmacology & Pharmacy
Meha Mehta, Normi Gajjar, Rutvi Patel, Lipi Joshi, Gaurang Shah
Summary: The objective of this study was to determine the frequency of genetic variants of cytochrome P450 enzymes and their impact on the efficacy of clopidogrel. The frequencies of CYP2C19*2, CYP2C9*2, and CYP2C9*3 were determined using allele-specific polymerase chain reaction (ASPCR). The presence of the CYP2C19*2 variant was associated with reduced efficacy of clopidogrel.
INDIAN JOURNAL OF PHARMACOLOGY
(2023)
Review
Pharmacology & Pharmacy
Marharyta Kamarova, Sheharyar Baig, Hamish Patel, Kimberley Monks, Mohammed Wasay, Ali Ali, Jessica Redgrave, Arshad Majid, Simon M. Bell
Summary: The literature review examines the use of antiplatelet agents for primary and secondary stroke prevention, including mechanism of action, cost, and reasons for lack of benefit. The review finds strong evidence supporting the use of aspirin and clopidogrel for secondary stroke prevention, but highlights the increased risk of hemorrhage with long-term combination therapy. Poor adherence and genetic polymorphisms are identified as factors contributing to antiplatelet treatment failure. The review also suggests that certain antiplatelet agents, such as cilostazol, may provide additional benefits in specific racial groups, but further research in diverse populations is needed. Overall, the review emphasizes the need for personalized therapies and future research in this field.
ANNALS OF PHARMACOTHERAPY
(2022)
Review
Pharmacology & Pharmacy
Sasidharan Pillai Aswathy, Kotha Rohith Chandra, Pakkath Jyothikrishna, Kanniappan Parthasarathy Arun
Summary: CYP2C19 genetic polymorphism affects the pharmacodynamics and pharmacokinetics of clopidogrel, requiring more attention in Asian populations. Utilizing pharmacogenetic information for treatment can help overcome these issues and optimize drug dosage.
Article
Pharmacology & Pharmacy
Brian Wood, Craig R. Lee, Ian R. Mulrenin, Megan N. Gower, Joseph S. Rossi, Karen E. Weck, George A. Stouffer
Summary: The study compared the clinical effectiveness of genotype-guided P2Y12 inhibitor selection following PCI in older and younger patients, finding that age influenced drug selection and the risk of major adverse cardiovascular events.
Article
Multidisciplinary Sciences
Rattanaporn Sukprasong, Sumonrat Chuwongwattana, Napatrupron Koomdee, Thawinee Jantararoungtong, Santirhat Prommas, Pimonpan Jinda, Jiratha Rachanakul, Nutthan Nuntharadthanaphong, Nutcha Jongjitsook, Apichaya Puangpetch, Chonlaphat Sukasem
Summary: This study examined the allele frequencies of cytochrome P450 polymorphisms in a Thai population and found significant differences in allele frequencies among different regions within Thailand. The results may contribute to understanding ethnic differences in drug responses and support the use of pharmacogenomics testing in clinical practice.
SCIENTIFIC REPORTS
(2021)
Article
Surgery
Megan Grinlinton, Stephen Sohn, Andrew Hill, Irene Zeng, Jenny Wagener
ANZ JOURNAL OF SURGERY
(2019)
Article
Orthopedics
J. T. K. Woon, I. S. L. Zeng, T. Calliess, H. Windhagen, M. Ettinger, H. B. Waterson, A. D. Toms, S. W. Young
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
(2018)
Article
Clinical Neurology
Elisabeth Taylor, Irene Zeng, Conor O'Dochartaigh
JOURNAL OF SLEEP RESEARCH
(2019)
Review
Surgery
Bruce Su'a, Senitila Tutone, Wiremu MacFater, Ahmed Barazanchi, Weisi Xia, Irene Zeng, Andrew G. Hill
ANZ JOURNAL OF SURGERY
(2020)
Article
Psychiatry
Lillian Ng, Irene Zeng, Coni Kalinowski, Peter Watson
AUSTRALASIAN PSYCHIATRY
(2019)
Article
Cardiac & Cardiovascular Systems
Gregory J. Wehner, Linyuan Jing, Christopher M. Haggerty, Jonathan D. Suever, Joseph B. Leader, Dustin N. Hartzel, H. Lester Kirchner, Joseph N. A. Manus, Nick James, Zina Ayar, Patrick Gladding, Christopher W. Good, John G. F. Cleland, Brandon K. Fornwalt
EUROPEAN HEART JOURNAL
(2020)
Article
Critical Care Medicine
Ahmed Barazanchi, Sameer Bhat, Kate Palmer-Neels, Wiremu S. Macfater, Weisi Xia, Irene Zeng, Ashish Taneja, Andrew D. MacCormick, Andrew G. Hill
JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
(2020)
Article
Cardiac & Cardiovascular Systems
Patrick A. Gladding, Suzanne Loader, Kevin Smith, Erica Zarate, Saras Green, Silas Villas-Boas, Phillip Shepherd, Purvi Kakadiya, Will Hewitt, Eric Thorstensen, Christine Keven, Margaret Coe, Bahareh Nakisa, Tan Vuong, Mohammad Naim Rastgoo, Mia Jullig, Vito Starc, Todd T. Schlegel
Summary: The study utilized multiomics and machine learning techniques to analyze patients with heart failure, showing that A-ECG and Echo AI can accurately diagnose HFrEF and have high correlation with other biomarkers. The virtual reality mental stress test affected the AECG results and autonomic response in HFrEF.
Article
Environmental Sciences
Shamshad Karatela, Neil Ward, Janis Paterson, Irene Suilan Zeng
Summary: This study used network analysis to investigate the association between micronutrients and child behavior and emotional outcomes. The results showed that exceeding manganese levels may have negative impacts on children's behavioral health and emotional well-being.
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
(2022)
Article
Health Care Sciences & Services
Clive Bensemann, Irene Suilan Zeng, Helen Hamer
Summary: Integrated care is expected to improve the healthcare utilization of patients with mental disorders. This study found that a locality based mental health integrated model of care can shorten the length of non-acute specialist care and reduce acute mental health admissions.
INTERNATIONAL JOURNAL OF INTEGRATED CARE
(2022)
Article
Respiratory System
William Good, Gene Jeon, Irene Zeng, Louanne Storey, Helen Qiao, Stuart Jones, Sarah Mooney, Lata Jayaram, David Holland, Conroy Wong
Summary: The study shows that sputum procalcitonin levels are significantly higher in patients with stable bronchiectasis compared to healthy controls, with higher levels in spontaneously expectorated sputum than induced sputum. Repeat measurements indicate that procalcitonin levels remain relatively stable one week later.
Meeting Abstract
Respiratory System
W. Good, G. Jeon, I Zeng, L. Storey, H. Qiao, S. Jones, S. Mooney, L. Jayaram, S. Taylor, D. Holland, C. Wong
Meeting Abstract
Respiratory System
W. Good, S. Mooney, I Zeng, S. Taylor, L. Jayaram, D. Holland, C. Wong
Article
Surgery
Hinetamatea Mikaere, Irene Zeng, Melanie Lauti, Malsha Kularatna, Andrew D. MacCormick
ANZ JOURNAL OF SURGERY
(2018)
Review
Biochemical Research Methods
Irene Sui Lan Zeng, Thomas Lumley
BIOINFORMATICS AND BIOLOGY INSIGHTS
(2018)