1
|
Zhang L, Meng Z, Wang H, Miao Y. Effect of PEAR1, PTGS1 gene polymorphisms on the recurrence of aspirin-treated patients with ischemic stroke in the Han population of China: A 4-year follow-up study. Medicine (Baltimore) 2024; 103:e38031. [PMID: 38728491 PMCID: PMC11081601 DOI: 10.1097/md.0000000000038031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 04/05/2024] [Indexed: 05/12/2024] Open
Abstract
Platelet endothelial aggregation receptor 1 (PEAR1) and prostaglandin endoperoxide synthase 1 (PTGS1) polymorphisms can affect laboratory aspirin resistance. However, the impact of genetic polymorphisms on the recurrence of ischemic stroke (IS) patients treated with aspirin is not fully understood. This study aimed to examine the relationship between gene polymorphisms of PEAR1 and PTGS1 and IS recurrence in patients treated with aspirin. Peripheral blood samples were collected from 174 patients with nonrecurrent IS and 34 with recurrent IS after aspirin treatment. Follow-up was performed on all patients. PEAR1 rs12041331 and PTGS1 rs10306114 polymorphisms were determined using the PCR fluorescence probe method. And the correlations of them with the clinical characteristics were examined by multivariable logistic regression analysis. The distribution frequencies of PEAR1 rs12041331 and PTGS1 rs10306114 genotypes were in Hardy-Weinberg equilibrium, and there was no significant difference in the distribution of PEAR1 rs12041331 polymorphism. Compared to the nonrecurrent group, the AA genotype of the PTGS1 polymorphism was more frequent in the recurrent group (59.77% vs 35.29%, P = .003), and the A allele also showed a higher frequency than the G allele in the recurrent group (P = .001). Multivariable logistic regression analysis showed that smoking (OR = 5.228, 95% CI: 1.938-14.102, P = .001), coronary heart disease (OR = 4.754, 95% CI: 1.498-15.089, P = .008), and the polymorphism at PTGS1(A>G) AA/AG + GG (OR = 2.955, 95% CI: 1.320-6.616, P = .008) were independently associated with IS recurrence in Chinese patients. Our findings suggested that PTGS rs10306114 polymorphisms should receive more attention in the use of aspirin in patients with IS.
Collapse
Affiliation(s)
- Linlin Zhang
- Department of Pharmacology, the First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu, China
| | - Zhongru Meng
- Department of Pharmacology, the First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu, China
| | - Hongxia Wang
- Department of Pharmacology, the First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu, China
| | - Yang Miao
- Department of Pharmacology, the First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu, China
| |
Collapse
|
2
|
Ye Z, Wang Q, Ullah I, Lin Q, Wu T, Yang M, Fan Y, Dong Z, Wang T, Teng J, Hua R, Tang Y, Li Y, Gong X, Yuan L, Tao Z, Li C. Impact of hemodialysis on efficacies of the antiplatelet agents in coronary artery disease patients complicated with end-stage renal disease. J Thromb Thrombolysis 2024; 57:558-565. [PMID: 38393676 PMCID: PMC11026285 DOI: 10.1007/s11239-023-02924-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 02/25/2024]
Abstract
It is controversial whether hemodialysis affects the efficacy of the antiplatelet agents. We aimed to investigate the impact of hemodialysis on efficacies of the antiplatelet agents in coronary artery disease (CAD) patients complicated with end-stage renal disease (ESRD). 86 CAD patients complicated with ESRD requiring hemodialysis were consecutively enrolled. After 5-day treatment with aspirin and clopidogrel or ticagrelor, the platelet aggregations induced by arachidonic acid (PLAA) or adenosine diphosphate (PLADP), and the P2Y12 reaction unit (PRU) were measured before and after hemodialysis. The propensity matching score method was adopted to generate a control group with normal renal function from 2439 CAD patients. In patients taking aspirin, the PLAA remained unchanged after hemodialysis. In patients taking clopidogrel, the PLADP (37.26 ± 17.04 vs. 31.77 ± 16.09, p = 0.029) and corresponding clopidogrel resistance (CR) rate (23 [48.9%] vs. 14 [29.8%], p = 0.022) significantly decreased after hemodialysis, though PRU remained unchanged. Subgroup analysis indicated that PLADP significantly decreased while using polysulfone membrane (36.8 ± 17.9 vs. 31.1 ± 14.5, p = 0.024). In patients taking ticagrelor, PLADP, and PRU remained unchanged after hemodialysis. ESRD patients had higher incidences of aspirin resistance (AR) and CR compared to those with normal renal function (AR: 16.1% vs. 0%, p = 0.001; CR: 48.4% vs. 24.8%, p = 0.024). Hemodialysis does not have negative effect on the efficacies of aspirin, clopidogrel and ticagrelor in ESRD patients with CAD. ESRD patients have higher incidences of AR and CR compared with those with normal renal function.Trial registration ClinicalTrials.gov Identifier: NCT03330223, first registered January 4, 2018.
Collapse
Affiliation(s)
- Zekang Ye
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Neurology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, China
| | - Qin Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Inam Ullah
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qingxia Lin
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Tianyu Wu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Mingwen Yang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuansheng Fan
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhou Dong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Tong Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jianzhen Teng
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Rui Hua
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yingdan Tang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yule Li
- College of Letters and Science, University of Wisconsin-Madison, Madison, WI , USA
| | - Xiaoxuan Gong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Liang Yuan
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Zhengxian Tao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Chunjian Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
| |
Collapse
|
3
|
Yazbeck A, Akika R, Awada Z, Zgheib NK. Pharmacogenetic considerations in therapy with novel antiplatelet and anticoagulant agents. Pharmacogenet Genomics 2024; 34:61-72. [PMID: 38372412 DOI: 10.1097/fpc.0000000000000520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Antiplatelets and anticoagulants are extensively used in cardiovascular medicine for the prevention and treatment of thrombosis in the venous and arterial circulations. Wide inter-individual variability has been observed in response to antiplatelets and anticoagulants, which triggered researchers to investigate the genetic basis of this variability. Data from extensive pharmacogenetic studies pointed to strong evidence of association between polymorphisms in candidate genes and the pharmacokinetics and pharmacodynamic action and clinical response of the antiplatelets clopidogrel and the anticoagulant warfarin. In this review, we conducted an extensive search on Medline for the time period of 2009-2023. We also searched the PharmGKB website for levels of evidence of variant-drug combinations and for drug labels and clinical guidelines. We focus on the pharmacogenetics of novel antiplatelets and anticoagulants while excluding acetylsalicylic acid, warfarin and heparins, and discuss the current knowledge with emphasis on the level of evidence.
Collapse
Affiliation(s)
| | - Reem Akika
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Zainab Awada
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nathalie K Zgheib
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
4
|
Jung IH, Stitziel NO. Integrin α9β1 deficiency does not impact the development of atherosclerosis in mice. Heliyon 2024; 10:e25760. [PMID: 38370227 PMCID: PMC10869861 DOI: 10.1016/j.heliyon.2024.e25760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/20/2024] Open
Abstract
Sushi, von Willebrand factor type A, EGF and pentraxin domain containing 1 (SVEP1) is an extracellular matrix protein that causally promotes cardiovascular disease in humans and mice. However, the receptor mediating the effect of SVEP1 on the development of disease remains unclear. We previously demonstrated that depleting either vascular smooth muscle cell (VSMC)- or myeloid cell-derived integrin α9β1, the first receptor that was identified to interact with SVEP1, did not phenocopy the disease-abrogating effect of depleting SVEP1. Due to its wide expression in tissues and cell types, here we extend this line of investigation to definitively determine if integrin α9β1 impacts the development of atherosclerosis. In a mouse model of atherosclerosis, we found that depleting integrin α9β1 in all cells did not alter plaque size or characteristics of plaque complexity when compared to wild type mice. Further, the significant SVEP1-mediated effects on increase in macrophage content and VSMC proliferation within the atherosclerotic plaque were not altered in animals lacking integrin α9β1. Together, these findings strongly suggest that integrin α9β1 is not responsible for mediating the SVEP1-induced promotion of atherosclerosis and support further studies aimed at characterizing other receptors whose interaction with SVEP1 may represent a therapeutically targetable interaction.
Collapse
Affiliation(s)
- In-Hyuk Jung
- Center for Cardiovascular Research, Division of Cardiology, Department of Medicine, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Nathan O. Stitziel
- Center for Cardiovascular Research, Division of Cardiology, Department of Medicine, Washington University School of Medicine, Saint Louis, MO, 63110, USA
- Department of Genetics, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| |
Collapse
|
5
|
Hou X. Epoxidase inhibitor-aspirin resistance and the relationship with genetic polymorphisms: a review. J Int Med Res 2024; 52:3000605241230429. [PMID: 38420770 PMCID: PMC10903214 DOI: 10.1177/03000605241230429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 01/18/2024] [Indexed: 03/02/2024] Open
Abstract
Strokes are the leading cause of death in most regions of the world. Epoxidase inhibitors include the drug aspirin (acetylsalicylic acid). Aspirin is widely used as first-line treatment for the prevention of cardiovascular and cerebrovascular diseases in at-risk patients. However, patients using conventional doses of aspirin can still develop ischaemic cardiovascular and cerebrovascular diseases, a phenomenon known as aspirin resistance. The occurrence of aspirin resistance hinders the prevention and treatment of ischaemic cardiovascular and cerebrovascular diseases. There are many factors affecting aspirin resistance, such as sex, drug dose, metabolic disease, genetic polymorphisms, drug interactions and pharmacokinetics. Genetic polymorphism refers to the simultaneous and frequent presence of two or more discontinuous variants or genotypes or alleles in a population of organisms. Platelets contain a large number of highly polymorphic transmembrane glycoprotein receptors encoded by two or more isomeric alleles. Changes in gene polymorphisms in various pathways during platelet aggregation can lead to aspirin resistance. This narrative review describes the gene polymorphisms that have been demonstrated to be significantly associated with aspirin resistance. Research on the mechanisms of aspirin resistance and increased knowledge should provide accurate drug guidance in individuals that require first-line antiplatelet therapy.
Collapse
Affiliation(s)
- Xiaolin Hou
- Department of Emergency Medicine, Zigong First People’s Hospital, Zigong City, China
| |
Collapse
|
6
|
Ye Z, Chen P, Tan C, Gong X, Li R, Dong Z, Ullah I, Zhou C, Zhou S, Xie L, Hou X, Han Z, Gu Q, Ma J, Teng J, Tang Y, Zhang Z, Hu H, Zhuang Q, Chen J, Zhu B, Shao F, Li C. Effects of ilaprazole on the steady-state pharmacodynamics of clopidogrel in healthy volunteers: An open-label randomized crossover study. Front Pharmacol 2022; 13:952804. [PMID: 36160382 PMCID: PMC9492925 DOI: 10.3389/fphar.2022.952804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Previous studies have suggested that proton pump inhibitors could impair the antiplatelet effect of clopidogrel. It is uncertain whether ilaprazole affects the antiplatelet effect of clopidogrel. This study aimed to determine the drug-drug interaction between ilaprazole and clopidogrel. Methods: A randomized crossover trial of 40 healthy subjects was performed. Clopidogrel was administered alone or in combination with ilaprazole for 7 days. The maximal platelet aggregation (MPA) to 5 μmol/L adenosine diphosphate was measured by light transmission aggregometry and the platelet reactivity index (PRI) was determined by vasodilator-stimulated phosphoprotein P2Y12 assay. High on-treatment platelet reactivity (HOPR) was defined as a MPA of >40%. The inhibition of platelet aggregation (IPA) and PRI in the two phases were compared between two regimens after the last dosing. Results: IPA was comparable between the two regimens at 0, 10 and 24 h (p > 0.05), but higher at 4 h in the clopidogrel alone regimen compared with that in the combined treatment regimen (75.66 ± 18.44% vs. 70.18 ± 17.67%, p = 0.031). The inhibition of PRI was comparable between the two regimens at 0 and 24 h. There were no significant differences in the area under the time-IPA% curve (AUC) or the incidence of HOPR at all time-points between the two regimens. Conclusion: In healthy subjects, ilaprazole has limited effect on the pharmacodynamics of clopidogrel and it may not be clinically relevant. Clinical Trial Registration: [www.chictr.org.cn], identifier [ChiCTR2000031482].
Collapse
Affiliation(s)
- Zekang Ye
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Pengsheng Chen
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Cardiology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China
| | - Chuchu Tan
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiaoxuan Gong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ran Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhou Dong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Inam Ullah
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chen Zhou
- Phase I Clinical Trial Unit, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Sufeng Zhou
- Phase I Clinical Trial Unit, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lijun Xie
- Phase I Clinical Trial Unit, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xuemei Hou
- Lizhu Medical Research Institute, Lizhu Group, Zhuhai, Guangdong, China
| | - Zhihui Han
- Lizhu Medical Research Institute, Lizhu Group, Zhuhai, Guangdong, China
| | - Qian Gu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jiazheng Ma
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jianzhen Teng
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yingdan Tang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhuanxia Zhang
- Lizhu Medical Research Institute, Lizhu Group, Zhuhai, Guangdong, China
| | - Haitang Hu
- Lizhu Medical Research Institute, Lizhu Group, Zhuhai, Guangdong, China
| | - Quankun Zhuang
- Phase I Clinical Trial Unit, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Juan Chen
- Phase I Clinical Trial Unit, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Bei Zhu
- Phase I Clinical Trial Unit, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Feng Shao
- Phase I Clinical Trial Unit, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Clinical Pharmacology, School of Pharmacy College, Nanjing Medical University, Nanjing, China
- *Correspondence: Feng Shao, ; Chunjian Li,
| | - Chunjian Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- *Correspondence: Feng Shao, ; Chunjian Li,
| |
Collapse
|
7
|
Hu X, Liu C, Zhang M, Zhang W. The impact of PEAR 1 polymorphism on clinical outcomes in Chinese patients receiving dual antiplatelet therapy after percutaneous coronary intervention. Pharmacogenomics 2022; 23:639-648. [PMID: 35880550 DOI: 10.2217/pgs-2022-0033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background: Patients might still experience major adverse cardiovascular events even with dual antiplatelet therapy after percutaneous coronary intervention. Our study aimed to explore the impact of gene polymorphism on clinical outcomes in one-year follow-up. Methods: A total of 171 patients treated with dual antiplatelet therapy after percutaneous coronary intervention from April to December 2020 in the first hospital of Jilin University enrolled in this study. Results: PEAR1 genetic polymorphisms was associated with the arachidonic acid (AA) and adenosine diphosphate (ADP) platelet aggregation. Hyperglycemia was associated with the rate of major adverse cardiovascular events. PEAR1 GA+AA genetic genetic polymorphisms is associated with hyperglycemia. Conclusion: PEAR1 GG is a risk factor for AA and ADP platelet aggregation. Hyperglycemia can effect the one-year outcome. PEAR1 GA+AA genetic polymorphisms are associated with hyperglycemia.
Collapse
Affiliation(s)
- Xinyuan Hu
- Genetic Diagnosis Center, The First Hospital of Jilin University, Changchun, 130021, China
| | - Chaoxi Liu
- Department of Cardiology, The First Hospital of Jilin University, Changchun, 130021, China
| | - Mingyou Zhang
- Department of Cardiology, The First Hospital of Jilin University, Changchun, 130021, China
| | - Weihua Zhang
- Department of Cardiology, The First Hospital of Jilin University, Changchun, 130021, China
| |
Collapse
|
8
|
Li Z, Jiang H, Ding Y, Zhang D, Zhang X, Xue J, Ma R, Hu L, Yue Y. Platelet Endothelial Aggregation Receptor 1 Polymorphism Is Associated With Functional Outcome in Small-Artery Occlusion Stroke Patients Treated With Aspirin. Front Cardiovasc Med 2021; 8:664012. [PMID: 34540909 PMCID: PMC8440843 DOI: 10.3389/fcvm.2021.664012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/31/2021] [Indexed: 01/05/2023] Open
Abstract
Background: The role of genetic polymorphisms is important in defining the patient's prognosis and outcomes in coronary artery disease. The present study aimed to explore the association between platelet endothelial aggregation receptor 1 (PEAR1) rs12041331 polymorphism and the outcomes in patients with acute ischemic stroke treated with aspirin or dual antiplatelet therapy (DAPT) with clopidogrel. Methods: A total of 868 ischemic stroke patients admitted to our hospital from January 1, 2016 to December 30, 2018 were retrospectively studied. The Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification defined stroke subtypes. These patients were treated with aspirin alone or DAPT. The genotype distribution of PEAR1 rs12041331 single-nucleotide polymorphism (AA, AC, and CC) between different TOAST subtypes and treatment groups was assessed, and the clinical impact of genetic variants on functional outcomes defined by the National Institutes of Health Stroke Scale, modified Rankin Scale, and Barthel Index was analyzed using univariate and multivariate logistic regression models. Results: Among the 868 stroke patients, the PEAR1 AA genotype was 16%, GA was 47%, and GG was 36%. Forty-four percent had aspirin alone, and 56% had DAPT. Overall, the distribution of PEAR single-nucleotide polymorphism was not significant among the two treatment groups or subtypes of TOAST. In contrast, in patients treated with aspirin alone, PEAR1 AA tended to be higher in the small-artery occlusion (SAO) subtype when compared with the no-lacunar subtype, including cardioembolism and large-artery atherosclerosis. PEAR1 AA genotype was significantly associated with favorable functional outcomes at day 7 and discharge only in SAO patients treated with aspirin alone compared with the GG genotype. Multivariate regression models further suggested that AA genotype was independently associated with favorable outcomes in this group after being adjusted for three common stroke risk factors such as age, hypertension history, and C-reactive protein level [odds ratio (OR) 0.23, 95% confidence interval (CI), 0.07–0.64, P = 0.02 for 7-day National Institutes of Health Stroke Scale; OR 0.2, 95% CI, 0.06–0.66, P = 0.03 for 7-day modified Rankin Scale, and OR 0.25, 95% CI, 0.08–0.72, P = 0.03 for 7-day Barthel Index, respectively]. Conclusion: The impact of PEAR1 rs12041331 polymorphism on aspirin depends on the TOAST subtype. PEAR1 AA carrier with SAO stroke is most sensitive to aspirin therapy. PEAR1 AA is an independent factor for the short-term functional outcomes in SAO patients treated with aspirin alone. Clinical Registration Number: 1800019911.
Collapse
Affiliation(s)
- Zhizhang Li
- Department of Neurology, Yangpu Hospital Tongji University School of Medicine, Shanghai, China
| | - Huayu Jiang
- Department of Neurology, Yangpu Hospital Tongji University School of Medicine, Shanghai, China
| | - Ying Ding
- Department of Neurology, Yangpu Hospital Tongji University School of Medicine, Shanghai, China
| | - Dong Zhang
- Department of Neurology, Yangpu Hospital Tongji University School of Medicine, Shanghai, China
| | - Xiaoguang Zhang
- Department of Neurology, Yangpu Hospital Tongji University School of Medicine, Shanghai, China
| | - Jie Xue
- Department of Neurology, Yangpu Hospital Tongji University School of Medicine, Shanghai, China
| | - Ruinan Ma
- Department of Neurology, Yangpu Hospital Tongji University School of Medicine, Shanghai, China
| | - Liang Hu
- Department of Neurology, Yangpu Hospital Tongji University School of Medicine, Shanghai, China
| | - Yunhua Yue
- Department of Neurology, Yangpu Hospital Tongji University School of Medicine, Shanghai, China
| |
Collapse
|
9
|
Duconge J, Santiago E, Hernandez-Suarez DF, Moneró M, López-Reyes A, Rosario M, Renta JY, González P, Ileana Fernández-Morales L, Antonio Vélez-Figueroa L, Arce O, Marín-Maldonado F, Nuñez H, Melin K, Scott SA, Ruaño G. Pharmacogenomic polygenic risk score for clopidogrel responsiveness among Caribbean Hispanics: A candidate gene approach. Clin Transl Sci 2021; 14:2254-2266. [PMID: 34415683 PMCID: PMC8604227 DOI: 10.1111/cts.13124] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/10/2021] [Accepted: 07/14/2021] [Indexed: 12/31/2022] Open
Abstract
This multicenter clinical study was aimed at conducting a targeted pharmacogenomic association analysis of residual on‐clopidogrel platelet reactivity in 474 Caribbean Hispanic patients. Platelet reactivity was measured using the VerifyNow P2Y12 assay and clopidogrel resistance was defined as P2Y12 reaction units (PRUs) greater than or equal to 208. Genotyping was performed using the whole‐genome Infinium MEGA BeadChip array. An ancestry‐adjusted, weighted polygenic risk score (wPGxRS) was developed to account for the effect of multiple variants on PRU and compared between clopidogrel responders and nonresponders. The mean PRU across the study cohort was 173.8 ± 68.5 and 33.5% of patients were defined as clopidogrel resistant. Multivariate linear regression showed that 19% of PRU variability was attributed to nine independent predictors, with CYP2C19*2 (rs4244285) accounting for ~ 7% of observed PRU variation (p < 0.001). PON1 rs662, ABCB1/MDR1 rs2032582, PEAR1 rs12041331 carrier status, and the interaction between African ancestry and rs12041331 carriers also predicted PRU among the participants (p ≤ 0.05). A clear gene‐dose effect was detected between PRU and CYP2C19*2 genotype, consistent with previous studies in European patient populations, as well as rs12777823. Importantly, a significant positive correlation was detected between our novel wPGxRS (4 variants) and PRU among the Hispanic patient population (rp = 0.35, p < 0.001). Moreover, the wPGxRS discriminated between nonresponders and responders (p = 0.003), indicating that this multigene‐based score is a useful predictor of clopidogrel resistance among Caribbean Hispanics. Taken together, these results help close the gap of knowledge on clopidogrel pharmacogenomics and its potential clinical implementation in this under‐represented population.
Collapse
Affiliation(s)
- Jorge Duconge
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Ednalise Santiago
- Research Centers in Minority Institutions (RCMI) Program, Center for Collaborative Research in Health Disparities (CCRHD), Academic Affairs Deanship, University of Puerto Rico - Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Dagmar F Hernandez-Suarez
- Division of Cardiovascular Medicine, School of Medicine, University of Puerto Rico - Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Mariangeli Moneró
- Department of Pharmacology, School of Medicine, University of Puerto Rico - Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Andrés López-Reyes
- Department of Biology, College of Natural Sciences, University of Puerto Rico - Rio Piedras Campus, San Juan, Puerto Rico, USA
| | - Marines Rosario
- Department of Biology, College of Natural Sciences, University of Puerto Rico - Rio Piedras Campus, San Juan, Puerto Rico, USA
| | - Jessicca Y Renta
- Research Centers in Minority Institutions (RCMI) Program, Center for Collaborative Research in Health Disparities (CCRHD), Academic Affairs Deanship, University of Puerto Rico - Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Pablo González
- Department of Pharmacology, School of Medicine, University of Puerto Rico - Medical Sciences Campus, San Juan, Puerto Rico, USA
| | | | | | - Orlando Arce
- School of Medicine, Universidad Central del Caribe, Bayamon, Puerto Rico, USA
| | - Frances Marín-Maldonado
- Research Centers in Minority Institutions (RCMI) Program, Center for Collaborative Research in Health Disparities (CCRHD), Academic Affairs Deanship, University of Puerto Rico - Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Héctor Nuñez
- Division of Cardiovascular Medicine, School of Medicine, University of Puerto Rico - Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Kyle Melin
- Department of Pharmacy Practice, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Stuart A Scott
- Department of Pathology, Stanford University, Palo Alto, California, USA
| | - Gualberto Ruaño
- Institute of Living at Hartford Hospital, Hartford, Connecticut, USA
| |
Collapse
|
10
|
Wang J, Han M, Kuang J, Tu J, Starcevich K, Gao P, Peng C, Yin S, Chen J, Zhang X, Jia W, Wu Y, Yi Y. Personalized antiplatelet therapy based on clopidogrel/aspirin resistance tests in acute ischemic stroke and transient ischemic attack: Study protocol of a multi-center, single-blinded and randomized controlled trial. Contemp Clin Trials 2021; 108:106507. [PMID: 34274496 DOI: 10.1016/j.cct.2021.106507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/06/2021] [Accepted: 07/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Clopidogrel and aspirin are key intervention for acute ischemic stroke (AIS) and transient ischemic attack (TIA). However, with increased clinical application, many patients have shown clopidogrel resistance (CR) and/or aspirin resistance (AR) that affect antiplatelet therapy on AIS/TIA. At present, there is no research reported on personalized antiplatelet therapy guidelines for patients with CR and/or AR. Our study aims to assess the effect of personalized antiplatelet therapy based on CYP2C19 genotype and urine 11-dhTxB2 tests in patients with AIS or TIA. METHODS This is a multi-center randomized controlled trial. Eligible patients with AIS/TIA from 14 comprehensive hospitals in Jiangxi province will be recruited after obtaining informed consent. Participants will be randomly divided into the intervention group and the control group at a ratio of 1:1. personalized antiplatelet therapy based on the CYP2C19 genotype/urine11-dhTxB2 tests will be given to the intervention group. Demographics, disease history, laboratory investigations, therapys, physiological tests, imaging reports and other clinical features will be collected. Clinical outcomes including stroke recurrence, Modified Rankin Scale (mRS) score, bleeding events and all-cause mortality will be assessed at the 1st, 3rd, 6th, and 12th-month post-discharge. DISCUSSION Our study will conduct free antiplatelet resistance tests and personalized antiplatelet therapy for AIS/TIA patients with CR/AR, ultimately evaluating personalized therapy effectiveness through one-year follow-up. The research results will help to assess the impact of personalized antiplatelet therapy on the prognosis of stroke, thus providing reference for precise clinical treatment.
Collapse
Affiliation(s)
- Jiajing Wang
- Medical Big Data Center, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang 330006, PR China; Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 461BaYi Road, Nanchang 330006, PR China
| | - Mengqi Han
- Medical Big Data Center, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang 330006, PR China; Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 461BaYi Road, Nanchang 330006, PR China
| | - Jie Kuang
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 461BaYi Road, Nanchang 330006, PR China.
| | - Jianglong Tu
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang 330006, PR China
| | - Katherine Starcevich
- School of Community Health Sciences, University of Nevada, Reno, 89557 Nevada, USA
| | - Peter Gao
- School of Community Health Sciences, University of Nevada, Reno, 89557 Nevada, USA
| | - Chen Peng
- Medical Big Data Center, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang 330006, PR China; Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 461BaYi Road, Nanchang 330006, PR China
| | - Shujuan Yin
- Medical Big Data Center, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang 330006, PR China; Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 461BaYi Road, Nanchang 330006, PR China
| | - Jibiao Chen
- Medical Big Data Center, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang 330006, PR China; Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 461BaYi Road, Nanchang 330006, PR China
| | - Xiaolin Zhang
- Medical Big Data Center, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang 330006, PR China; Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 461BaYi Road, Nanchang 330006, PR China
| | - Weijie Jia
- Medical Big Data Center, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang 330006, PR China; Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 461BaYi Road, Nanchang 330006, PR China
| | - Yifan Wu
- Medical Big Data Center, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang 330006, PR China; Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 461BaYi Road, Nanchang 330006, PR China
| | - Yingping Yi
- Medical Big Data Center, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang 330006, PR China.
| |
Collapse
|
11
|
Zhang X, Li S, Zhao Y, Tang N, Jia T, Zhou P, Liu J, Shi L, Lu CY, Nie X. Genetic variants of PEAR1 and ischemic clinical outcomes in coronary artery disease patients: a systematic review and meta-analysis. Pharmacogenomics 2021; 22:641-648. [PMID: 34075782 DOI: 10.2217/pgs-2021-0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Aim: The aim of this study was to assess the association between PEAR1 polymorphisms and ischemic clinical outcomes. Materials & methods: We searched the electronic database for articles on the relationship of PEAR1 SNPs and ischemic events in patients with coronary artery disease (CAD) up to October 2020. Results: A total of 9914 patients with CAD from six studies focusing on 12 SNPs of PEAR1 were included in this study. The A allele of rs12041331 were associated with ischemic events (odds ratio: 1.40; 95% CI: 1.04-1.88; p = 0.03). The AA homozygotes of rs2768759 was related to a higher risk of ischemic events than carriers of the C allele (odds ratio: 2.08; 95% CI: 1.09-3.97; p = 0.03). Conclusion: PEAR1 rs12041331 and rs2768759 are significantly associated with ischemic events in patients with CAD.
Collapse
Affiliation(s)
- Xinyi Zhang
- Department of Pharmacy Administration & Clinical Pharmacy, School of Pharmaceutical Science, Peking University, Beijing, 100191, China
| | - Sicong Li
- Department of Pharmacy Administration & Clinical Pharmacy, School of Pharmaceutical Science, Peking University, Beijing, 100191, China
| | - Yuxuan Zhao
- Department of Pharmacy Administration & Clinical Pharmacy, School of Pharmaceutical Science, Peking University, Beijing, 100191, China
| | - Ningjia Tang
- Department of Pharmacy Administration & Clinical Pharmacy, School of Pharmaceutical Science, Peking University, Beijing, 100191, China
| | - Tong Jia
- Department of Pharmacy Administration & Clinical Pharmacy, School of Pharmaceutical Science, Peking University, Beijing, 100191, China
| | - Pei Zhou
- Department of Cardiology, Peking University Third Hospital, Beijing, 100191, China
| | - Jian Liu
- Department of Cardiology, Peking University People's Hospital, Beijing, 100044, China
| | - Luwen Shi
- Department of Pharmacy Administration & Clinical Pharmacy, School of Pharmaceutical Science, Peking University, Beijing, 100191, China
| | - Christine Y Lu
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
| | - Xiaoyan Nie
- Department of Pharmacy Administration & Clinical Pharmacy, School of Pharmaceutical Science, Peking University, Beijing, 100191, China.,Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
| |
Collapse
|
12
|
Zhang XG, Gu JY, Fu QQ, Chen SW, Xue J, Jiang SS, Kong YM, Li YM, Yue YH. Impact of Platelet Endothelial Aggregation Receptor-1 Genotypes on Long-Term Cerebrovascular Outcomes in Patients With Minor Stroke or Transient Ischemic Attack. Front Neurol 2021; 12:649056. [PMID: 34135847 PMCID: PMC8202184 DOI: 10.3389/fneur.2021.649056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/19/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Platelet endothelial aggregation receptor-1 (PEAR1) rs12041331 has been reported to affect agonist-stimulated platelet aggregation, but it remains unclear whether this variant plays a role in recurrent stroke. Here we assess the clinical relevance of PEAR1 rs12041331 in acute minor ischemic stroke (AMIS) and transient ischemic attack (TIA) Chinese patients treated with dual antiplatelet therapy (DAPT). Methods: We recruited 273 consecutive minor stroke and TIA patients, and Cox proportional hazard regression was used to model the relationship between PEAR1 rs12041331 and thrombotic and bleeding events. Results: Genotyping for PEAR1 rs12041331 showed 49 (18.0%) AA homozygotes, 129 (47.3%) GA heterozygotes, and 95 (34.7%) GG homozygotes. No association was observed between PEAR1 rs12041331 genotype and stroke or composite clinical vascular event rates (ischemic stroke, hemorrhagic stroke, TIA, myocardial infarction, or vascular death) or bleeding events regardless if individuals carried one or two copies of the A allele. Our results suggested that rs12041331 genetic polymorphism was not an important contributor to clinical events in AMIS and TIA patients in the setting of secondary prevention. Conclusions: Our data do provide robust evidence that genetic variation in PEAR1 rs12041331 do not contribute to atherothrombotic or bleeding risk in minor stroke and TIA patients treated with DAPT.
Collapse
Affiliation(s)
- Xiao-Guang Zhang
- Department of Neurology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jing-Yu Gu
- Department of Neurology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qiang-Qiang Fu
- Department of Neurology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shi-Wu Chen
- Department of Neurology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jie Xue
- Department of Neurology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shan-Shan Jiang
- Department of Neurology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yu-Ming Kong
- Department of Neurology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
| | - You-Mei Li
- Department of Neurology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yun-Hua Yue
- Department of Neurology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
| |
Collapse
|
13
|
Banihani SA, Shatnawi RM. Aspirin decreases human sperm motility and vitality, chelates seminal calcium, but insignificantly reduces seminal nitric oxide production. Andrologia 2020; 52:e13776. [DOI: 10.1111/and.13776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/29/2020] [Accepted: 07/04/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Saleem A. Banihani
- Department of Medical Laboratory Sciences Jordan University of Science and Technology Irbid Jordan
| | - Reema M. Shatnawi
- Department of Medical Laboratory Sciences Jordan University of Science and Technology Irbid Jordan
| |
Collapse
|
14
|
Lewis JP, Riaz M, Xie S, Polekhina G, Wolfe R, Nelson M, Tonkin AM, Reid CM, Murray AM, McNeil JJ, Shuldiner AR, Lacaze P. Genetic Variation in PEAR1, Cardiovascular Outcomes and Effects of Aspirin in a Healthy Elderly Population. Clin Pharmacol Ther 2020; 108:1289-1298. [PMID: 32562573 DOI: 10.1002/cpt.1959] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/04/2020] [Indexed: 01/04/2023]
Abstract
The platelet endothelial aggregation receptor-1 (PEAR1) rs12041331 variant has been identified as a genetic determinant of platelet aggregation in response to antiplatelet therapies, including aspirin. However, association with atherothrombotic cardiovascular events is less clear, with limited evidence from large trials. Here, we tested association of rs12041331 with cardiovascular events and aspirin use in a randomized trial population of healthy older individuals. We undertook post hoc analysis of 13,547 participants of the ASPirin in Reducing Events in the Elderly (ASPREE) trial, median age 74 years. Participants had no previous diagnosis of atherothrombotic cardiovascular disease at enrollment, and were randomized to either 100 mg daily low-dose aspirin or placebo for median 4.7 years follow-up. We used Cox proportional hazard regression to model the relationship between rs12041331 and the ASPREE primary cardiovascular disease (CVD) end point, and composites of major adverse cardiovascular events (MACE) and ischemic stroke (STROKE); and bleeding events; major hemorrhage (MHEM) and intracranial bleeding (ICB). We performed whole-population analysis using additive and dominant inheritance models, then stratified by treatment group. Interaction effects between genotypes and treatment group were examined. We observed no statistically significant association (P < 0.05) in the population, or by treatment group, between rs12041331 and cardiovascular or bleeding events in either model. We also found no significant interaction effects between rs12041331-A and treatment group, for CVD (P = 0.65), MACE (P = 0.32), STROKE (P = 0.56), MHEM (P = 0.59), or ICB (P = 0.56). The genetic variant PEAR1 rs12041331 is not associated with cardiovascular events in response to low-dose aspirin in a healthy elderly population.
Collapse
Affiliation(s)
- Joshua P Lewis
- Department of Medicine, Program for Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Moeen Riaz
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sophia Xie
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Galina Polekhina
- Department of Medicine, Program for Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Rory Wolfe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mark Nelson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Andrew M Tonkin
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Christopher M Reid
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Anne M Murray
- Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Hennepin Healthcare, Minneapolis, Minnesota, USA
| | - John J McNeil
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alan R Shuldiner
- Department of Medicine, Program for Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Paul Lacaze
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
15
|
Yuan D, Shi X, Guo L, Wang G, Zhao Y, Yang Y, Zhang H, Huang Q, Yuan Y. Lower Platelet Aggregation Is a Risk Factor for Dual Antiplatelet Therapy-Associated Bleeding: A Preliminary Retrospective Study with Genotype Analysis. Med Sci Monit 2020; 26:e923758. [PMID: 32541641 PMCID: PMC7318838 DOI: 10.12659/msm.923758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background The purpose of this study was to investigate factors influencing bleeding in patients with acute coronary syndrome (ACS) who are on aspirin and ticagrelor as dual antiplatelet therapy. Material/Methods This retrospective case-control study included 50 patients with ACS (25 with reported bleeding events and 25 without) on aspirin and ticagrelor. Adenosine diphosphate (ADP)- and arachidonic acid (ACA)-induced platelet aggregation rates were measured using light transmission aggregometry. Single-nucleotide polymorphisms (SNPs) in PEAR1, GP1BA, and GSTP1 were genotyped. Results ACA-induced platelet aggregation rates were obviously lower in patients with bleeding events than in those without (13.28±8.46% vs. 24.93±9.89%, P<0.001). No significant differences in ADP-induced platelet aggregation rates were observed between the 2 groups (16.17±9.74% vs. 16.88±12.69%, P>0.05). Among those with bleeding events and among controls, 70% and 80% had an ACA-induced platelet aggregation rate of 0–18% and 18–50%, respectively. Mutation rates of rs6065 in GP1BA and rs1695, rs4891, and rs8191439 in GSTP1 also differed significantly between the 2 groups. Conclusions Lower ACA-induced platelet aggregation rates are associated with increased risk of bleeding in patients with ACS who are on aspirin and ticagrelor. An ACA-induced platelet aggregation rate of 18% may be considered the cutoff point for identifying high risk of aspirin-associated bleeding events in patients with ACS. SNP genotyping may also help predict the risk of bleeding in patients with ACS.
Collapse
Affiliation(s)
- Dongdong Yuan
- Department of Cardiology, The 7th People's Hospital of Zhengzhou, Zhengzhou, Henan, China (mainland)
| | - Xiangfen Shi
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Liping Guo
- Department of Cardiology, The 7th People's Hospital of Zhengzhou, Zhengzhou, Henan, China (mainland)
| | - Gaobiao Wang
- Department of Cardiology, The 7th People's Hospital of Zhengzhou, Zhengzhou, Henan, China (mainland)
| | - Yujie Zhao
- Department of Cardiology, The 7th People's Hospital of Zhengzhou, Zhengzhou, Henan, China (mainland)
| | - Yuling Yang
- Department of Cardiology, The 7th People's Hospital of Zhengzhou, Zhengzhou, Henan, China (mainland)
| | - Hanjuan Zhang
- Department of Cardiology, The 7th People's Hospital of Zhengzhou, Zhengzhou, Henan, China (mainland)
| | - Qiong Huang
- Department of Cardiology, The 7th People's Hospital of Zhengzhou, Zhengzhou, Henan, China (mainland)
| | - Yiqiang Yuan
- Department of Cardiology, The 7th People's Hospital of Zhengzhou, Zhengzhou, Henan, China (mainland)
| |
Collapse
|
16
|
Abstract
Platelet Endothelial Aggregation Receptor (PEAR1), as a platelet receptor, plays a vital role in hemostasis. This receptor, by its extracellular part, causes platelet adhesion and consequently initiates platelet aggregation. Dysfunction of PEAR1 can disrupt platelet aggregation in patients with cardiovascular diseases (CVDs). The content used in this paper has been taken from English language articles (2005-2020) retrieved from Pubmed database and Google scholar search engine using "Cardiovascular Disease", "PEAR1", "Polymorphism", and "Platelet Aggregation" keywords. Some PEAR1 polymorphisms can disrupt homeostasis and interfere with the function mechanism of cardiac drugs. Since polymorphisms in this gene affect platelet function and the platelet aggregation process, PEAR1 could be further studied in the future as an essential factor in controlling the treatment process of patients with cardiovascular diseases. PEAR1 polymorphisms through disruption of the platelet aggregation process can be a risk factor in patients with CVDs. Therefore, controlling patients through genetic testing and the evaluation of PEAR1 polymorphisms can help improve the treatment process of patients. According to the studies on the PEAR1 gene and the effect of different polymorphisms on some crucial issues in CVDs patients (changes in platelet activity), it is clear that if there is a significant relationship between polymorphisms and CVDs, they can be used as prognostic and diagnostic markers. This study aims to evaluate the prognosis and drug treatment of the PEAR1 gene in CVDs patients.
Collapse
|
17
|
Banihani SA. Effect of aspirin on semen quality: A review. Andrologia 2019; 52:e13487. [DOI: 10.1111/and.13487] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/02/2019] [Accepted: 11/01/2019] [Indexed: 12/12/2022] Open
Affiliation(s)
- Saleem A. Banihani
- Department of Medical Laboratory Sciences Jordan University of Science and Technology Irbid Jordan
| |
Collapse
|