P2Y12 Reaction Units and Clinical Outcomes in Acute Large Artery Atherosclerotic Stroke: A Multicenter Prospective Study.


Journal

Journal of atherosclerosis and thrombosis
ISSN: 1880-3873
Titre abrégé: J Atheroscler Thromb
Pays: Japan
ID NLM: 9506298

Informations de publication

Date de publication:
01 Jan 2023
Historique:
pubmed: 8 3 2022
medline: 6 1 2023
entrez: 7 3 2022
Statut: ppublish

Résumé

We aimed to determine the association between acute platelet reactivity and clinical outcome in acute ischemic stroke (AIS) or transient ischemic attack (TIA) with large-artery atherosclerosis (LAA). In this prospective, 16-multicenter study, we enrolled AIS/TIA patients with LAA receiving clopidogrel. We assessed the association of P2Y12 reaction units (PRU) 24 hours after initiation of antiplatelets with the CYP2C19 genotype and recurrent ischemic stroke within 90 days, and the difference between acute (≤ 7 days) and subacute (8-90 days) phases. Among the 230 AIS/TIA patients enrolled, 225 with complete outcome data and 194 with genetic results were analyzed. A higher PRU was significantly associated with recurrent ischemic stroke within 90 days (frequency, 16%), and within 7 days (10%). Twenty-nine patients (15%) belonged to a CYP2C19 poor metabolizer group (CYP2C19 Acute PRU evaluation possesses predictive value for recurrent ischemic stroke, especially within 7 days in AIS/TIA with LAA.

Identifiants

pubmed: 35249906
doi: 10.5551/jat.63369
pmc: PMC9899699
doi:

Substances chimiques

Platelet Aggregation Inhibitors 0
Ticlopidine OM90ZUW7M1
Cytochrome P-450 CYP2C19 EC 1.14.14.1

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

39-55

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Auteurs

Kazuki Fukuma (K)

Department of Neurology, National Cerebral and Cardiovascular Center.

Hiroshi Yamagami (H)

Division of Stroke Care Unit, National Cerebral and Cardiovascular Center.
Department of Stroke Neurology, National Hospital Organization Osaka National Hospital.

Masafumi Ihara (M)

Department of Neurology, National Cerebral and Cardiovascular Center.

Tomotaka Tanaka (T)

Department of Neurology, National Cerebral and Cardiovascular Center.

Toshiyuki Miyata (T)

Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.

Shigeki Miyata (S)

Department of Clinical Laboratory Medicine, National Cerebral and Cardiovascular Center.
Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center.

Koichi Kokame (K)

Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center.

Kunihiro Nishimura (K)

Departments of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center.

Yuriko Nakaoku (Y)

Departments of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center.

Haruko Yamamoto (H)

Center for Advancing Clinical and Translational Sciences, National Cerebral and Cardiovascular Center.

Mikito Hayakawa (M)

Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.

Kenji Kamiyama (K)

Department of Neurosurgery, Nakamura Memorial Hospital.

Yukiko Enomoto (Y)

Department of Neurosurgery, Gifu University Graduate School of Medicine.

Ryo Itabashi (R)

Department of Stroke Neurology, Kohnan Hospital.

Eisuke Furui (E)

Department of Stroke Neurology, Kohnan Hospital.

Yasuhiro Manabe (Y)

Department of Neurology, National Hospital Organization Okayama Medical Center.

Masayuki Ezura (M)

Department of Neurosurgery, National Hospital Organization Sendai Medical Center.

Kenichi Todo (K)

Department of Neurology, Kobe City Medical Center General Hospital.

Kazuo Hashikawa (K)

Department of Stroke Neurology, National Hospital Organization Osaka National Hospital.

Shinichiro Uchiyama (S)

Clinical Research Center for Medicine, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center.

Kazunori Toyoda (K)

Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.

Kazuyuki Nagatsuka (K)

Department of Neurology, National Cerebral and Cardiovascular Center.

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