Effect of Calcium Channel Blockers on Antiplatelet Activity of Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention: Insights from the PTRG-DES Consortium
Aims: Calcium channel blockers (CCBs) are frequently co-administered with clopidogrel in cardiovascular disease. Although an inhibitory drug interaction exists between them, comprehensive large-scale studies for its validation are lacking. We investigated interactions between CCBs and clopidogrel us...
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SAGE Publishing
2024-11-01
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| Series: | Journal of Cardiovascular Pharmacology and Therapeutics |
| Online Access: | https://doi.org/10.1177/10742484241298150 |
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| author | HoungBeom Ahn MD Hyun-Wook Chu MD Ae-Young Her MD, PhD Young-Hoon Jeong MD, PhD Byeong-Keuk Kim MD, PhD Hyung Joon Joo MD, PhD Kiyuk Chang MD, PhD Yongwhi Park MD, PhD Sung Gyun Ahn MD, PhD Sang Yeup Lee MD, PhD Jung Rae Cho MD, PhD Hyo-Soo Kim MD, PhD Moo Hyun Kim MD, PhD Do-Sun Lim MD, PhD Eun-Seok Shin MD, PhD Jung-Won Suh MD, PhD |
| author_facet | HoungBeom Ahn MD Hyun-Wook Chu MD Ae-Young Her MD, PhD Young-Hoon Jeong MD, PhD Byeong-Keuk Kim MD, PhD Hyung Joon Joo MD, PhD Kiyuk Chang MD, PhD Yongwhi Park MD, PhD Sung Gyun Ahn MD, PhD Sang Yeup Lee MD, PhD Jung Rae Cho MD, PhD Hyo-Soo Kim MD, PhD Moo Hyun Kim MD, PhD Do-Sun Lim MD, PhD Eun-Seok Shin MD, PhD Jung-Won Suh MD, PhD |
| author_sort | HoungBeom Ahn MD |
| collection | DOAJ |
| description | Aims: Calcium channel blockers (CCBs) are frequently co-administered with clopidogrel in cardiovascular disease. Although an inhibitory drug interaction exists between them, comprehensive large-scale studies for its validation are lacking. We investigated interactions between CCBs and clopidogrel using a large-scale national registry of patients who underwent percutaneous coronary intervention (PCI). Methods and Results: The Platelet function and genoType-Related long-term Prognosis-Platelet Function Test consortium investigates the association between platelet function test and long-term prognosis during dual antiplatelet therapy including clopidogrel in patients using drug-eluting stents. We compared the ex vivo platelet reactivity using the VerifyNow P2Y12 test and clinical outcomes between CCB users and non-users. Between 2003 and 2018, 11 714 patients were enrolled and categorized into two groups according to CCB usage. A composite endpoint encompassing all-cause mortality, myocardial infarction, stent thrombosis, or stroke was defined as a major adverse cardiac and cerebrovascular event (MACCE). During the 5-year follow-up period, no significant differences were observed in P2Y12 reaction units (215.8 ± 84.7 vs 218.4 ± 76.7, P = .156), MACCEs, major bleeding, or high platelet reactivity rates, even after adjusting for propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). When limited to the high platelet reactivity cohort (≥252 PRU), the results remained consistent for MACCE [PSM-adjusted, HR: 0.923 (0.644-1.323), P -value .663; IPTW-adjusted, HR: 1.300 (0.822-2.056), P -value .262]. Conclusions: CCB and clopidogrel co-administration does not appear to significantly impact clopidogrel responsiveness or clinical outcomes. Despite these promising results, further investigation may be warranted. Clinical trial registration: Platelet Function and genoType-Related Long-term progGosis in DES-treated Patients: A Consortium From Multi-centered Registries [PTRG-DES]; NCT04734028 |
| format | Article |
| id | doaj-art-bcadf80ab3ea4b5a853da1218d58d3c2 |
| institution | Kabale University |
| issn | 1940-4034 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Cardiovascular Pharmacology and Therapeutics |
| spelling | doaj-art-bcadf80ab3ea4b5a853da1218d58d3c22024-11-18T12:03:19ZengSAGE PublishingJournal of Cardiovascular Pharmacology and Therapeutics1940-40342024-11-012910.1177/10742484241298150Effect of Calcium Channel Blockers on Antiplatelet Activity of Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention: Insights from the PTRG-DES ConsortiumHoungBeom Ahn MD0Hyun-Wook Chu MD1Ae-Young Her MD, PhD2Young-Hoon Jeong MD, PhD3Byeong-Keuk Kim MD, PhD4Hyung Joon Joo MD, PhD5Kiyuk Chang MD, PhD6Yongwhi Park MD, PhD7Sung Gyun Ahn MD, PhD8Sang Yeup Lee MD, PhD9Jung Rae Cho MD, PhD10Hyo-Soo Kim MD, PhD11Moo Hyun Kim MD, PhD12Do-Sun Lim MD, PhD13Eun-Seok Shin MD, PhD14Jung-Won Suh MD, PhD15 Department of Internal Medicine, , Seoul, South Korea Department of Cardiology, , Hallym University College of Medicine, Seoul, South Korea Division of Cardiology, Department of Internal Medicine, , Chuncheon, South Korea Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea Severance Cardiovascular Hospital, , Seoul, South Korea Department of Cardiology, Cardiovascular Center, , Korea University College of Medicine, Seoul, South Korea Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea Division of Cardiology, Department of Medicine, Gyeongsang National University School of Medicine, Changwon, South Korea Department of Cardiology, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea Division of Cardiology, , Gwangmyeong, South Korea Cardiology Division, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea Department of Internal Medicine and Cardiovascular Center, , Seoul, South Korea Department of Cardiology, , Busan, South Korea Department of Cardiology, Cardiovascular Center, , Korea University College of Medicine, Seoul, South Korea Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea Department of Internal Medicine, , Seoul, South KoreaAims: Calcium channel blockers (CCBs) are frequently co-administered with clopidogrel in cardiovascular disease. Although an inhibitory drug interaction exists between them, comprehensive large-scale studies for its validation are lacking. We investigated interactions between CCBs and clopidogrel using a large-scale national registry of patients who underwent percutaneous coronary intervention (PCI). Methods and Results: The Platelet function and genoType-Related long-term Prognosis-Platelet Function Test consortium investigates the association between platelet function test and long-term prognosis during dual antiplatelet therapy including clopidogrel in patients using drug-eluting stents. We compared the ex vivo platelet reactivity using the VerifyNow P2Y12 test and clinical outcomes between CCB users and non-users. Between 2003 and 2018, 11 714 patients were enrolled and categorized into two groups according to CCB usage. A composite endpoint encompassing all-cause mortality, myocardial infarction, stent thrombosis, or stroke was defined as a major adverse cardiac and cerebrovascular event (MACCE). During the 5-year follow-up period, no significant differences were observed in P2Y12 reaction units (215.8 ± 84.7 vs 218.4 ± 76.7, P = .156), MACCEs, major bleeding, or high platelet reactivity rates, even after adjusting for propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). When limited to the high platelet reactivity cohort (≥252 PRU), the results remained consistent for MACCE [PSM-adjusted, HR: 0.923 (0.644-1.323), P -value .663; IPTW-adjusted, HR: 1.300 (0.822-2.056), P -value .262]. Conclusions: CCB and clopidogrel co-administration does not appear to significantly impact clopidogrel responsiveness or clinical outcomes. Despite these promising results, further investigation may be warranted. Clinical trial registration: Platelet Function and genoType-Related Long-term progGosis in DES-treated Patients: A Consortium From Multi-centered Registries [PTRG-DES]; NCT04734028https://doi.org/10.1177/10742484241298150 |
| spellingShingle | HoungBeom Ahn MD Hyun-Wook Chu MD Ae-Young Her MD, PhD Young-Hoon Jeong MD, PhD Byeong-Keuk Kim MD, PhD Hyung Joon Joo MD, PhD Kiyuk Chang MD, PhD Yongwhi Park MD, PhD Sung Gyun Ahn MD, PhD Sang Yeup Lee MD, PhD Jung Rae Cho MD, PhD Hyo-Soo Kim MD, PhD Moo Hyun Kim MD, PhD Do-Sun Lim MD, PhD Eun-Seok Shin MD, PhD Jung-Won Suh MD, PhD Effect of Calcium Channel Blockers on Antiplatelet Activity of Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention: Insights from the PTRG-DES Consortium Journal of Cardiovascular Pharmacology and Therapeutics |
| title | Effect of Calcium Channel Blockers on Antiplatelet Activity of Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention: Insights from the PTRG-DES Consortium |
| title_full | Effect of Calcium Channel Blockers on Antiplatelet Activity of Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention: Insights from the PTRG-DES Consortium |
| title_fullStr | Effect of Calcium Channel Blockers on Antiplatelet Activity of Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention: Insights from the PTRG-DES Consortium |
| title_full_unstemmed | Effect of Calcium Channel Blockers on Antiplatelet Activity of Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention: Insights from the PTRG-DES Consortium |
| title_short | Effect of Calcium Channel Blockers on Antiplatelet Activity of Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention: Insights from the PTRG-DES Consortium |
| title_sort | effect of calcium channel blockers on antiplatelet activity of clopidogrel in patients undergoing percutaneous coronary intervention insights from the ptrg des consortium |
| url | https://doi.org/10.1177/10742484241298150 |
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