Effect of cilostazol on optimized standard antiplatelet therapy in a patient with a cytochrome P450 2C19 *2/*2 genotype

被引:0
作者
Fu Q. [1 ]
Suzuki N. [1 ]
Takada K. [1 ]
Yamamoto H. [1 ]
Ishikawa S. [1 ]
Yokoyama N. [1 ]
Kozuma K. [1 ]
Isshiki T. [1 ]
机构
[1] Department of Medicine, Teikyo University School of Medicine, Tokyo, 2-11-1 Kaga, Itabashi-ku
关键词
Acute coronary syndrome; Antiplatelet therapy; Coronary intervention; Stent thrombosis;
D O I
10.1007/s12928-010-0036-x
中图分类号
学科分类号
摘要
A 54-year-old man with acute coronary syndrome underwent primary percutaneous coronary intervention (PCI) to implant a bare metal stent. Three weeks later, a subclinical in-stent thrombus was found at staged PCI despite dual antiplatelet therapy with aspirin and clopidogrel. Platelet function tests revealed high post-treatment platelet reactivity, indicating an inadequate response to clopidogrel. The patient's cytochrome P450 2C19 genotype was *2/*2. Cilostazol at 200 mg/day was initiated in addition. Three months later, platelet inhibition was enhanced, and no thrombus was detectable by coronary angiography. Our experience suggests that triple antiplatelet therapy with cilostazol as well as aspirin and clopidogrel could prevent stent thrombosis with improved clopidogrel responsiveness. © 2010 Japanese Association of Cardiovascular Intervention and Therapeutics.
引用
收藏
页码:79 / 82
页数:3
相关论文
共 13 条
[1]  
Mehta S.R., Yusuf S., Peters R.J., Bertrand M.E., Lewis B.S., Natarajan M.K., Et al., Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study, Lancet, 358, pp. 527-533, (2001)
[2]  
Angiolillo D.J., Fernandez-Ortiz A., Bernardo E., Alfonso F., Macaya C., Bass T.A., Et al., Variability in individual responsiveness to clopidogrel: clinical implications, management, and future perspectives, J Am Coll Cardiol, 49, pp. 1505-1516, (2007)
[3]  
Buonamici P., Marcucci R., Migliorini A., Gensini G.F., Santini A., Paniccia R., Et al., Impact of platelet reactivity after clopidogrel administration on drug-eluting stent thrombosis, J Am Coll Cardiol, 49, pp. 2312-2317, (2007)
[4]  
Iakovou I., Schmidt T., Bonizzoni E., Ge L., Sangiorgi G.M., Stankovic G., Et al., Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents, Jama, 293, pp. 2126-2130, (2005)
[5]  
Lemesle G., Delhaye C., Bonello L., de Labriolle A., Waksman R., Pichard A., Stent thrombosis in 2008: definition, predictors, prognosis and treatment, Arch Cardiovasc Dis, 101, pp. 769-777, (2008)
[6]  
Liu X., Doi H., Maehara A., Mintz G.S., de Costa Jr. R.J., Sano K., Et al., A volumetric intravascular ultrasound comparison of early drug-eluting stent thrombosis versus restenos, JACC Cardiovasc Interv., 2, pp. 428-434, (2009)
[7]  
Matetzky S., Shenkman B., Guetta V., Shechter M., Bienart R., Goldenberg I., Et al., Clopidogrel resistance is associated with increased risk of recurrent atherothrombotic events in patients with acute myocardial infarction, Circulation, 109, pp. 3171-3175, (2004)
[8]  
Simon T., Verstuyft C., Mary-Krause M., Quteineh L., Drouet E., Meneveau N., Et al., Genetic determinants of response to clopidogrel and cardiovascular events, N Engl J Med, 360, pp. 363-375, (2009)
[9]  
Mega J.L., Close S.L., Wiviott S.D., Shen L., Hockett R.D., Brandt J.T., Et al., Cytochrome p-450 polymorphisms and response to clopidogrel, N Engl J Med, 360, pp. 354-362, (2009)
[10]  
Jinnai T., Horiuchi H., Makiyama T., Tazaki J., Tada T., Akao M., Et al., Impact of CYP2C19 polymorphisms on the antiplatelet effect of clopidogrel in an actual clinical setting in Japan, Circ J, 73, pp. 1498-1503, (2009)