The Personalization Of Clopidogrel Antiplatelet Therapy In Coronary Artery Disease Patients Using Pharmacometabonomics, Pharmacogenetics And Platelets Function Testing

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dc.contributor.authorMostafa, Arwa Mohamed Amin
dc.date.accessioned2017-01-05T01:42:00Z
dc.date.available2017-01-05T01:42:00Z
dc.date.issued2016-09
dc.description.abstractClopidogrel is a substantial antiplatelet drug. Some patients on clopidogrel treatment suffer from high on treatment platelets reactivity (HTPR) which may lead to poor outcome. Genotyping of CYP2C19 had been recommended to predict clopidogrel response. However, this might be insufficient to predict the response. Pharmacometbonomics analysis using nuclear magnetic resonance (1H-NMR) spectroscopy can help to identify novel biomarkers of HTPR in plasma and urine. The primary aim of this project was to evaluate the use of pharmacometabonomics, pharmacogenetics and platelets function testing for the personalization of clopidogrel anti-platelet therapy in coronary artery disease patients. Secondary objectives included determining the frequency of CYP2C19 *2 and *3 polymorphisms and the frequency of clopidogrel HTPR. Moreover, this study aimed to evaluate the effect of CYP2C19 polymorphisms and other non-genetic factors on clopidogrel response. A total of 89 CAD patients planned for interventional angiographic procedure (IAP) were recruited and genotyped for CYP2C19*2 and *3. Out of those, 71 patients were loaded with clopidogrel 600 mg. Blood and urine samples were collected from patients before loading and 6 hours after loading for the pharmacometabonomics analysis. Patients were assessed for platelets function testing (PFT) using the VerifyNow-P2Y12 kit at 6 hours after loading. Multivariate analysis was used to find the discriminating metabolites. Out of the 89 recruited patients, 38 (42.7%) and 15 (16.9%) were carriersClopidogrel is a substantial antiplatelet drug. Some patients on clopidogrel treatment suffer from high on treatment platelets reactivity (HTPR) which may lead to poor outcome. Genotyping of CYP2C19 had been recommended to predict clopidogrel response. However, this might be insufficient to predict the response. Pharmacometbonomics analysis using nuclear magnetic resonance (1H-NMR) spectroscopy can help to identify novel biomarkers of HTPR in plasma and urine. The primary aim of this project was to evaluate the use of pharmacometabonomics, pharmacogenetics and platelets function testing for the personalization of clopidogrel anti-platelet therapy in coronary artery disease patients. Secondary objectives included determining the frequency of CYP2C19 *2 and *3 polymorphisms and the frequency of clopidogrel HTPR. Moreover, this study aimed to evaluate the effect of CYP2C19 polymorphisms and other non-genetic factors on clopidogrel response. A total of 89 CAD patients planned for interventional angiographic procedure (IAP) were recruited and genotyped for CYP2C19*2 and *3. Out of those, 71 patients were loaded with clopidogrel 600 mg. Blood and urine samples were collected from patients before loading and 6 hours after loading for the pharmacometabonomics analysis. Patients were assessed for platelets function testing (PFT) using the VerifyNow-P2Y12 kit at 6 hours after loading. Multivariate analysis was used to find the discriminating metabolites. Out of the 89 recruited patients, 38 (42.7%) and 15 (16.9%) were carriersen_US
dc.identifier.urihttp://hdl.handle.net/123456789/3316
dc.subjectThe use of pharmacometabonomics, pharmacogenetics and platelets function testing for the personalizationen_US
dc.subjectof clopidogrel anti-platelet therapy in coronary artery disease patientsen_US
dc.titleThe Personalization Of Clopidogrel Antiplatelet Therapy In Coronary Artery Disease Patients Using Pharmacometabonomics, Pharmacogenetics And Platelets Function Testingen_US
dc.typeThesisen_US
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