clinical analysis of the pharmacological interactions of clopidogrel and gender differences a case-control study临床药理分析病例对照研究的氯吡格雷和性别差异的交互.pdfVIP

International Journal of Clinical Medicine, 2012, 3, 518-523 / 10.4236/ijcm.2012.36093 Published Online November 2012 (http://www.SciRP.org/journal/ijcm) Clinical Analysis of the Pharmacological Interactions of * Clopidogrel and Gender Differences: A Case-Control Study Bianchi Stefano, Chiara Casellato, Bianchini Erica, Scanavacca Paola Department of Pharmacy, University Hospital of Ferrara, Ferrara, Italy. Email: s.bianchi@ospfe.it Received July 29th, 2012; revised August 26th, 2012; accepted September 14th, 2012 ABSTRACT Background: Clopidogrel is a prodrug metabolized by cytochrome P450-2C19. Drugs inhibiting this enzyme might re- duce its antiplatelet activity. In order to reduce gastrointestinal bleedings, proton-pump inhibitors are usually prescribed in association with clopidogrel. The study aims at assessing the clinical importance of interactions between clopidogrel and inhibitors of CYP2C19. It also aims to evaluate any possible factors that may reduce the therapeutic efficacy of the drug. Particular attention was devoted to possible gender differences in responsiveness to treatment with clopidogrel or clopidogrel plus proton-pump inhibitors. This analysis is a retrospective case-control observational study carried out by the University Hospital of Ferrara. Methods: Subjects were patients who had received clopidogrel from 01-01-2008 to 31-12-2008. For them, we analysed hospital admissions and data of drug prescriptions relative to dispensing of drugs cytochrome P-450-2C19 inhibitors. Patients were subdivided into case and control groups based on the occurrence or not of cardiovascular or cerebrovascular secondary events during therapy with clopidogrel. Results: The study focused on 781 patients, 20.1% of which (n.157) experienced secondary effects. The mean age is 70 years old. Men (67% of the a