TY  - BOOK
AU  - Mina Wageh Mohareb
AU  - Hala Fahmy Zaki , 
AU  - Hanan Salah Eldin Elabhar , 
AU  - Mohamed Abdelghany Karim  , 
TI  - Combined effect of diabetes and cyp2c19 polymorphism on  clopidogrel vs ticagrelor anti-platelet activity in patients of anterior st elevation myocardial infarction undergoing primary PCI / 
PY  - 2020///
CY  - Cairo : 
PB  - Mina Wageh Mohareb , 
KW  - Acute coronary
KW  - Clopidogrel
KW  - Cyp2c19 polymorphism
N1  - Thesis (Ph.D.) - Cairo University - Faculty of Pharmacy - Department of Pharmacology and Toxicology; Issued also as CD
N2  - Background: Diabetes and CYP2C19 loss of function (LOF) alleles are associated with variable antiplatelet activity of the prodrug clopidogrel. Objective: We conducted the current observational trial (NCT03613857) to compare the combined and individualized  effects  of diabetes and CYP2C19 polymorphisms on the recurrence of ACS and anti-platelet activity  of clopidogrelvsticagrelor in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI).  Patients and interventions: Patients (948, 1 year follow-up 943) were randomly allocated in a 1:1 ratio to receive either clopidogrel or ticagrelor; following PCI; patients were sub-divided into eight groups according to the diabetes and/or CYP2C19 allele statusOutcome measures: The study 1ryoutcome was the recurrent ACS, whereas high platelet reactivity index (PRI),maximum platelet aggregation (MPA) and incidence of major bleeding events were considered the 2ryoutcomes. Results: Diabetic patients with LOF alleles taking clopidogrel had the highest recurrent ACS rate (6 out of 33 patients) vs all study groups (p<0.05). However, both drugs had equally prevented recurrent ACS in all other groups.Similarly,high PRI/MPA was significantly higher in the diabetic patients having LOF alleles and receiving clopidogrelvs ticagrelor group. Nevertheless, ticagrelor caused higher rates of major bleeding vsclopidogrel (p<0.001), and this necessitates. Indeed, the presence of either diabetes or LOF (+) alone had milder impact on the primary and secondary outcomes,respectively
UR  - http://172.23.153.220/th.pdf
ER  -