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https://hdl.handle.net/2440/129200
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Type: | Journal article |
Title: | Clinical outcomes associated with proton pump inhibitor use among clopidogrel-treated patients within CYP2C19 genotype groups following acute myocardial infarction |
Author: | Depta, J.P. Lenzini, P.A. Lanfear, D.E. Wang, T.Y. Spertus, J.A. Bach, R.G. Cresci, S. |
Citation: | The Pharmacogenomics Journal, 2015; 15(1):20-25 |
Publisher: | Nature Publishing Group |
Issue Date: | 2015 |
ISSN: | 1470-269X 1473-1150 |
Statement of Responsibility: | J P Depta, P A Lenzini, D E Lanfear, T Y Wang, J A Spertus, R G Bach and S Cresci |
Abstract: | We examined clinical outcomes with proton pump inhibitors (PPI) use within CYP2C19 genotype groups during clopidogrel treatment following acute myocardial infarction (AMI). 2062 patients were genotyped for CYP2C19*2 and *17 variants in TRIUMPH. 12 month clinical outcomes were analyzed among patients discharged on clopidogrel within CYP2C19*2 carrier, CYP2C19*17 carrier, and CYP2C19*1 homozygote genotype groups. PPI use was not associated with a difference in mortality. Among clopidogrel-treated Caucasians following AMI, PPI use was associated with a significantly higher rate of cardiac rehospitalization (HR 1.62, 95% CI 1.19-2.19; P=0.002) compared with no PPI use. PPI users who were carriers of the CYP2C19*17 variant experienced significantly higher rates of cardiac rehospitalization (HR 2.05, 95% CI 1.26-3.33; P=0.003), carriers of the CYP2C19*2 variant had a trend toward increased 1-year cardiac rehospitalization (HR 1.69, 95% CI 0.95-2.99; P=0.07), while no significant differences were observed among CYP2C19*1 homozygotes. These results indicate that the risks associated with PPI use among clopidogrel-treated Caucasian post-MI patients are impacted by CYP2C19 genotype, and suggest knowledge of genotype may be useful for personalizing PPI use among patients following AMI to reduce rehospitalization. |
Keywords: | Myocardial Infarction |
Rights: | © 2015 Macmillan Publishers Limited All rights reserved |
DOI: | 10.1038/tpj.2014.28 |
Published version: | http://dx.doi.org/10.1038/tpj.2014.28 |
Appears in Collections: | Aurora harvest 4 Pharmacology publications |
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