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Antiplatelet Effect of Clopidogrel Can Be Reduced by Calcium-Channel Blockers

Authors
 Kwon-Duk Seo  ;  Young Dae Kim  ;  Young-Won Yoon  ;  Jong-Youn Kim  ;  Kyung-Yul Lee 
Citation
 Yonsei Medical Journal, Vol.55(3) : 683-688, 2014 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2014
Abstract
PURPOSE: Clopidogrel is metabolized by the hepatic cytochrome P450 (CYP) system into its active thiol metabolite. CYP3A4 is involved in the metabolism of both clopidogrel and dihydropyridine calcium channel blockers (CCBs). A few reports have suggested an inhibitory interaction between CCBs and clopidogrel. Accordingly, the aim of this study was to determine the effect of CCBs on the antiplatelet activity of clopidogrel by serial P2Y12 reaction unit (PRU) measurements. MATERIALS AND METHODS: We assessed changes in antiplatelet activity in patients receiving both clopidogrel and CCBs for at least 2 months prior to enrollment in the study. The antiplatelet activity of clopidogrel was measured by VerifyNow P2Y12 assay in the same patient while medicated with CCBs and at 8 weeks after discontinuation of CCBs. After discontinuation of the CCBs, angiotensin receptor blockers were newly administered to the patients or dosed up for control of blood pressure. RESULTS: Thirty patients finished this study. PRU significantly decreased after discontinuation of CCBs (238.1±74.1 vs. 215.0±69.3; p=0.001). Of the 11 patients with high post-treatment platelet reactivity to clopidogrel (PRU≥275), PRU decreased in nine patients, decreasing below the cut-off value in seven of these nine patients after 8 weeks. Decrease in PRU was not related to CYP2C19 genotype.
Files in This Item:
T201400937.pdf Download
DOI
10.3349/ymj.2014.55.3.683
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김영대(Kim, Young Dae) ORCID logo https://orcid.org/0000-0001-5750-2616
서권덕(Seo, Kwon Duk)
윤영원(Yoon, Young Won) ORCID logo https://orcid.org/0000-0002-0907-0350
이경열(Lee, Kyung Yul) ORCID logo https://orcid.org/0000-0001-5585-7739
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98486
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