Pharmacodynamic Effect of Cilostazol Plus Standard Clopidogrel Versus Double-Dose Clopidogrel in Patients With Type 2 Diabetes Undergoing Percutaneous Coronary Intervention

• Autores: Young-Hoon Jeong, Udaya S. Tantry, Yongwhi Park, Tae Jung Kwon, Jeong Rang Park, Seok-Jae Hwang, Kevin P. Bliden, Eun-Ha Koh, Kwak Choong Hwan, Jin-Yong Hwang, Sunjoo Kim, Paul A. Gurbel
• Localización: Diabetes care, ISSN-e 0149-5992, Vol. 35, Nº. 11, 2012, págs. 2194-2197
• Idioma: inglés
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• Resumen

  • To determine the effect of adding cilostazol (100 mg b.i.d.) to standard-dose Clopidogrel (75 mg/d) (TRIPLE) compared with double-dose Clopidogrel (150 mg/d) (DOUBLE) and the influence of the cytochrome P450 (CYP2C19*2/*3, CYP3A5*3) and ATP-binding cassette subfamily Bl(ABCBl C3435T) genetic polymorphisms in type 2 diabetes (T2DM) patients. T2DM patients were treated with TRIPLE (n = 41) or DOUBLE (n = 39) after percutaneous coronary intervention. Conventional aggregometry and VerifyNow were performed at baseline and at 30 days. The primary end point was absolute change in 20-?M ADP-induced maximal platelet aggregation (?MOA^sub 20^) between baseline and switching values. TRIPLE versus DOUBLE showed greater ?MOA^sub 20^ (22.9 ± 11.6vs.l2.7 ± 15.5%; difference, 10.2% [95% CI 4.2-16.3]; P < 0.001). Carriage of one (? coefficient, -5.4%; P = 0.162) and two CYP2C19 loss-of-function allele(s) (-8.3%; P = 0.007) were associated with lower ?MOA^sub 20^ in DOUBLE-treated patients, but not in TRIPLE-treated patients. Among T2DM patients, adding cilostazol achieves greater platelet inhibition compared with Clopidogrel (150 mg/d), which is not influenced by genetic polymorphisms. [PUBLICATION ABSTRACT]