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J-GLOBAL ID：201802271303410655   整理番号：18A0435976

経皮的冠動脈インターベンション後のCYP2C19遺伝子型誘導抗血小板療法の実装による転帰の多施設研究【Powered by NICT】

Multisite Investigation of Outcomes With Implementation of CYP2C19 Genotype-Guided Antiplatelet Therapy After Percutaneous Coronary Intervention

著者 (71件)： Cavallari Larisa H. (Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, Florida) ,  Lee Craig R. (Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy and McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina) ,  Beitelshees Amber L. (Department of Medicine, University of Maryland, Baltimore, Maryland) ,  Cooper-DeHoff Rhonda M. (Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, Florida) ,  Cooper-DeHoff Rhonda M. (Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida) ,  Duarte Julio D. (Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, Illinois) ,  Voora Deepak (Department of Medicine, Center for Applied Genomics & Precision Medicine, Duke University, Durham, North Carolina) ,  Kimmel Stephen E. (University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania) ,  McDonough Caitrin W. (Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, Florida) ,  Gong Yan (Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, Florida) ,  Dave Chintan V. (Department of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, Florida) ,  Pratt Victoria M. (Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana) ,  Alestock Tameka D. (Department of Medicine, University of Maryland, Baltimore, Maryland) ,  Anderson R. David (Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida) ,  Alsip Jorge (Division of Cardiovascular Sciences, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama) ,  Ardati Amer K. (Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois) ,  Brott Brigitta C. (Division of Cardiovascular Sciences, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama) ,  Brown Lawrence (Veterans Administration Medical Center, Baltimore, Maryland) ,  Chumnumwat Supatat (Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, Illinois) ,  Clare-Salzler Michael J. (Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, Florida) ,  Coons James C. (Department of Pharmacy and Therapeutics, Center for Clinical Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania) ,  Denny Joshua C. (Departments of Biomedical Informatics and Medicine, Vanderbilt University Medical Center, Nashville, Tennessee) ,  Dillon Chrisly (Department of Neurology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama) ,  Elsey Amanda R. (Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, Florida) ,  Hamadeh Issam S. (Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, Florida) ,  Harada Shuko (Department of Pathology and Hugh Kaul Personalized Medicine Institute, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama) ,  Hillegass William B. (Heart South Cardiovascular Group, Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama) ,  Hines Lindsay (Department of Neuropsychology, University of North Dakota, Fargo, North Dakota) ,  Horenstein Richard B. (Department of Medicine, University of Maryland, Baltimore, Maryland) ,  Howell Lucius A. (Division of Cardiology and McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina) ,  Jeng Linda J.B. (Department of Medicine, University of Maryland, Baltimore, Maryland) ,  Kelemen Mark D. (Department of Medicine, University of Maryland, Baltimore, Maryland) ,  Lee Yee Ming (Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, Illinois) ,  Magvanjav Oyunbileg (Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, Florida) ,  Montasser May (Department of Medicine, University of Maryland, Baltimore, Maryland) ,  Nelson David R. (College of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, Florida) ,  Nutescu Edith A. (Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, Illinois) ,  Nutescu Edith A. (Department of Pharmacy Systems, Outcomes and Policy and Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago College of Pharmacy, Chicago, Illinois) ,  Nwaba Devon C. (Department of Medicine, University of Maryland, Baltimore, Maryland) ,  Pakyz Ruth E. (Department of Medicine, University of Maryland, Baltimore, Maryland) ,  Palmer Kathleen (Department of Medicine, University of Maryland, Baltimore, Maryland) ,  Peterson Josh F. (Departments of Biomedical Informatics and Medicine, Vanderbilt University Medical Center, Nashville, Tennessee) ,  Pollin Toni I. (Department of Medicine, University of Maryland, Baltimore, Maryland) ,  Quinn Alison H. (Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, Illinois) ,  Robinson Shawn W. (Department of Medicine, University of Maryland, Baltimore, Maryland) ,  Robinson Shawn W. (Veterans Administration Medical Center, Baltimore, Maryland) ,  Schub Jamie (Department of Medicine, University of Maryland, Baltimore, Maryland) ,  Skaar Todd C. (Department of Medicine, Krannert Institute of Cardiology & Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana) ,  Smith D. Max (Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, Florida) ,  Sriramoju Vindhya B. (Division of Cardiology and McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina) ,  Starostik Petr (Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, Florida) ,  Stys Tomasz P. (Department of Medicine, University of South Dakota, Sanford School of Medicine, Sioux Falls, South Dakota) ,  Stevenson James M. (Department of Pharmacy and Therapeutics, Center for Clinical Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania) ,  Varunok Nicholas (Division of Cardiology and McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina) ,  Vesely Mark R. (Department of Medicine, University of Maryland, Baltimore, Maryland) ,  Vesely Mark R. (Veterans Administration Medical Center, Baltimore, Maryland) ,  Wake Dyson T. (Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, Florida) ,  Weck Karen E. (Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina) ,  Weitzel Kristin W. (Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, Florida) ,  Wilke Russell A. (Department of Medicine, University of South Dakota, Sanford School of Medicine, Sioux Falls, South Dakota) ,  Willig James (Division of Cardiovascular Sciences, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama) ,  Zhao Richard Y. (Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland) ,  Kreutz Rolf P. (Department of Medicine, Krannert Institute of Cardiology & Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana) ,  Stouffer George A. (Division of Cardiology and McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina) ,  Empey Philip E. (Department of Pharmacy and Therapeutics, Center for Clinical Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania) ,  Limdi Nita A. (Department of Neurology and Hugh Kaul Personalized Medicine Institute, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama) ,  Shuldiner Alan R. (Department of Medicine, University of Maryland, Baltimore, Maryland) ,  Winterstein Almut G. (Department of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, Florida) ,  Winterstein Almut G. (Department of Epidemiology, Colleges of Medicine and Public Health and Health Professions, University of Florida, Gainesville, Florida) ,  Johnson Julie A. (Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, Florida) ,  Johnson Julie A. (Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida)
資料名： JACC: Cardiovascular Interventions  (JACC: Cardiovascular Interventions)
巻： 11  号： 2  ページ： 181-191  発行年： 2018年 
JST資料番号： W3127A  ISSN： 1936-8798  資料種別： 逐次刊行物 (A)
記事区分： 原著論文  発行国： オランダ (NLD)  言語： 英語 (EN)

抄録/ポイント： 多施設実用的研究は,経皮的冠動脈インターベンション(PCI)後のCYP2C19遺伝子型誘導抗血小板療法の臨床実施後の結果を評価した。CYP2C19機能喪失対立遺伝子はPCI後のクロピドグレル有効性を損なう。臨床遺伝子型判定した結果,各施設は機能喪失対立遺伝子を有するPCI患者における代替抗血小板療法(プラスグレル,チカグレロル)を推奨した。PCIの12か月以内の主要な有害心血管イベント(心筋梗塞,脳卒中または死亡と定義)は機能喪失対立遺伝子規定されたクロピドグレル対代替療法患者間で比較した。リスクも機能喪失対立遺伝子を持たない患者の間で比較し,機能喪失対立遺伝子キャリアは代替療法を処方した。Cox回帰を行い,処理量の逆確率で群間差を調整した。1,815名の患者のうち,572(31.5%)は機能喪失対立遺伝子を持っていた。主要有害心血管イベントのリスクは機能喪失対立遺伝子規定されたクロピドグレル対代替療法(23.4対8.7 100患者-年;調整ハザード比:2.26;95%信頼区間:1.18~4.32;P=0.013)患者で有意に高かった。同様の結果が,PCI(補正ハザード比:2.87;95%信頼区間:1.35~6.09;P=0.013)時間での急性冠動脈症候群患者1,210例間で観察された。機能喪失対立遺伝子を持たない患者の間の主要な有害心血管イベントの差ではなく,機能喪失対立遺伝子キャリアは代替療法(補正ハザード比:1.14;95%信頼区間:0.69~1.88;P=0.60)を処方した。クロピドグレル対代替療法が規定されている場合実世界観測から得られたデータは,CYP2C19機能喪失対立遺伝子を有する患者における心血管イベントの高いリスクを示した。遺伝子型誘導抗血小板療法の将来の無作為化試験は価値がある可能性がある。Copyright 2018 Elsevier B.V., Amsterdam. All rights reserved. Translated from English into Japanese by JST.【Powered by NICT】

シソーラス用語： *遺伝子型 ,  代替医療 ,  患者 ,  心筋梗塞 ,  ランダム化比較試験 ,  脳卒中 ,  対立遺伝子 ,  *経皮的冠動脈インターベンション ,  信頼区間
準シソーラス用語： 急性冠動脈症候群 ,  ハザード比 ,  心血管イベント ,  *抗血小板療法 ,  *CYP2C19遺伝子 , 【Automatic Indexing@JST】

著者キーワード (6件)： 抗血小板療法 ,  心血管イベント ,  クロピドグレル ,  CYP2C19 ,  経皮的冠動脈インターベンション ,  薬理ゲノミクス

分類 (2件)： 循環系の疾患  (GJ03000C) ,  循環系の診断  (GJ02000V)

物質索引 (1件)： クロピドグレル

タイトルに関連する用語 (8件)： 経皮的冠動脈インターベンション ,  CYP2C19遺伝子 ,  誘導 ,  抗血小板療法 ,  実装 ,  転帰 ,  施設 ,  研究