Korean Journal of Laboratory Medicine最新文献_第4页

Diagnostic performance of high-sensitivity troponin T, myeloperoxidase, and pregnancy-associated plasma protein A assays for triage of patients with acute myocardial infarction. 高灵敏度肌钙蛋白T、髓过氧化物酶和妊娠相关血浆蛋白A检测在急性心肌梗死患者分诊中的诊断价值

Korean Journal of Laboratory Medicine Pub Date : 2011-07-01 Epub Date: 2011-06-28 DOI: 10.3343/kjlm.2011.31.3.172

Dilshad Ahmed Khan, Mariam S Sharif, Farooq Ahmad Khan

{"title":"Diagnostic performance of high-sensitivity troponin T, myeloperoxidase, and pregnancy-associated plasma protein A assays for triage of patients with acute myocardial infarction.","authors":"Dilshad Ahmed Khan, Mariam S Sharif, Farooq Ahmad Khan","doi":"10.3343/kjlm.2011.31.3.172","DOIUrl":"https://doi.org/10.3343/kjlm.2011.31.3.172","url":null,"abstract":"Background: Early diagnosis is the cornerstone of management of acute myocardial infarction (AMI). We aimed to compare the diagnostic accuracy of high-sensitivity troponin T (hs-cTnT) with myeloperoxidase (MPO) and pregnancy-associated plasma protein A (PAPP-A) for early diagnosis of AMI in patients at the time of presentation to the emergency department (ED).Methods: We enrolled 289 patients who presented at the ED of the National Institute of Heart Disease (NIHD) Rawalpindi, Pakistan, within 4 hr of onset of chest pain. Clinical assessment, electrocardiography (ECG), and angiography were carried out. Blood samples were collected at 0, 3, 6, and 12 hr. Analyses of plasma hs-cTnT, MPO, and PAPP-A were carried out using commercial kits.Results: Out of 289 subjects who presented to the ED, we diagnosed 180 patients with coronary heart disease as having AMI (N= 61) and 119 as without AMI (stable coronary artery disease, N=61; unstable angina, N=58). Compared to non-AMI patients, the patients with AMI had significantly higher levels (represented here as median [inter quartile range]) of plasma hs-cTnT (136 [39-370] vs. 12 [7-21] ng/L), MPO (906 [564-1,631] vs. 786 [351-1,299] pmol/L) and PAPP-A (5.78 [2.67-13.4] vs. 2.8 [1.8-4.9] mIU/L). Receiver operator characteristic curves (95% CI) for hs-cTnT (0.952 [0.909-0.978]) were significantly higher (P<0.001) than those for MPO (0.886 [0.830-0.929]) and PAPP-A (0.797 [0.730-0.854]), with AMI sensitivity and specificity percentages of 87% and 98% (hs-cTnT), 82% and 84% (MPO), and 65% and 87% (PAPP-A), respectively.Conclusions: The diagnostic performance of hs-cTnT was superior to that of MPO and PAPP-A for early triage and diagnosis of AMI among patients of coronary heart disease presenting with chest pain to the ED.","PeriodicalId":17890,"journal":{"name":"Korean Journal of Laboratory Medicine","volume":"31 3","pages":"172-8"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3343/kjlm.2011.31.3.172","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30023067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 21

Human bocavirus in patients with respiratory tract infection. 人类呼吸道感染患者中的博卡病毒。

Korean Journal of Laboratory Medicine Pub Date : 2011-07-01 Epub Date: 2011-06-28 DOI: 10.3343/kjlm.2011.31.3.179

Jang Su Kim, Chae Seung Lim, Young Kee Kim, Kap No Lee, Chang Kyu Lee

{"title":"Human bocavirus in patients with respiratory tract infection.","authors":"Jang Su Kim, Chae Seung Lim, Young Kee Kim, Kap No Lee, Chang Kyu Lee","doi":"10.3343/kjlm.2011.31.3.179","DOIUrl":"https://doi.org/10.3343/kjlm.2011.31.3.179","url":null,"abstract":"Background: Human bocavirus (HBoV) is a newly identified viral pathogen, and its clinical epidemiology and significance in respiratory infections have not yet been completely elucidated. We investigated the prevalence of HBoV infection and the association between viral (HBoV) load and clinical features of the infection in patients of all age-groups.Methods: Nasopharyngeal aspirates from patients with symptoms of respiratory infection were tested for presence of HBoV by using real-time polymerase chain reaction. HBoV-positive patients were categorized into low- and high-viral-load groups using 1.0×10(6) copies/mL as the threshold value of viral load.Results: Detection rate of HBoV was 4.8% (N=93) in a total of 1,926 samples with peak incidence of infection being observed in patients aged 6-12 months. HBoV infection was more frequently observed in young children, especially, in children aged less than 5 yr, and the HBoV load decreased with increase in age. HBoV was codetected with other respiratory viruses in 17 (18.3%) of the 93 HBoV-positive patients and 15 patients (88.2%) belonged to the low-viral-load group. Patients infected with HBoV alone showed a higher viral load than those patients in whom HBoV was codetected with other respiratory viruses (median load, 3.78×10(5) copies/mL vs. 1.94×10(4) copies/mL, P=0.014). Higher pulse rate (P=0.007) and respiratory rate (P=0.021) were observed in patients with a high-viral-load.Conclusions: Our results suggest that HBoV may be the causative agent of respiratory infection in the high-viral-load group.","PeriodicalId":17890,"journal":{"name":"Korean Journal of Laboratory Medicine","volume":"31 3","pages":"179-84"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3343/kjlm.2011.31.3.179","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30023068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 26

Comparative quantitative analysis of cluster of differentiation 45 antigen expression on lymphocyte subsets. 分化簇45抗原在淋巴细胞亚群上表达的比较定量分析。

Korean Journal of Laboratory Medicine Pub Date : 2011-07-01 Epub Date: 2011-06-28 DOI: 10.3343/kjlm.2011.31.3.148

Mijeong Im, Hyojin Chae, Taehoon Kim, Hun-Hee Park, Jihyang Lim, Eun-Jee Oh, Yonggoo Kim, Yeon-Joon Park, Kyungja Han

{"title":"Comparative quantitative analysis of cluster of differentiation 45 antigen expression on lymphocyte subsets.","authors":"Mijeong Im, Hyojin Chae, Taehoon Kim, Hun-Hee Park, Jihyang Lim, Eun-Jee Oh, Yonggoo Kim, Yeon-Joon Park, Kyungja Han","doi":"10.3343/kjlm.2011.31.3.148","DOIUrl":"https://doi.org/10.3343/kjlm.2011.31.3.148","url":null,"abstract":"Background: Since the recent introduction of radioimmunotherapy (RIT) using antibodies against cluster of differentiation (CD) 45 for the treatment of lymphoma, the clinical significance of the CD45 antigen has been increasing steadily. Here, we analyzed CD45 expression on lymphocyte subsets using flow cytometry in order to predict the susceptibility of normal lymphocytes to RIT.Methods: Peripheral blood specimens were collected from 14 healthy individuals aged 25-54 yr. The mean fluorescence intensity (MFI) of the cell surface antigens was measured using a FACSCanto II system (Becton Dickinson Bioscience, USA). MFI values were converted into antibody binding capacity values using a Quantum Simply Cellular microbead kit (Bangs Laboratories, Inc., USA).Results: Among the lymphocyte subsets, the expression of CD45 was the highest (725,368±42,763) on natural killer T (NKT) cells, 674,030±48,187 on cytotoxic/suppressor T cells, 588,750±48,090 on natural killer (NK) cells, 580,211±29,168 on helper T (Th) cells, and 499,436±21,737 on B cells. The Th cells and NK cells expressed a similar level of CD45 (P=0.502). Forward scatter was the highest in NKT cells (P<0.05), whereas side scatter differed significantly between each of the lymphocyte subsets (P<0.05). CD3 expression was highest in the Th and NKT cells.Conclusions: NKT cells express the highest levels of CD45 antigen. Therefore, this lymphocyte subset would be most profoundly affected by RIT or pretargeted RIT. The monitoring of this lymphocyte subset during and after RIT should prove helpful.","PeriodicalId":17890,"journal":{"name":"Korean Journal of Laboratory Medicine","volume":"31 3","pages":"148-53"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3343/kjlm.2011.31.3.148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30024250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 15

Evaluation of the diagnostic performance of fibrin monomer in disseminated intravascular coagulation. 纤维蛋白单体在弥散性血管内凝血诊断中的价值评价。

Korean Journal of Laboratory Medicine Pub Date : 2011-07-01 Epub Date: 2011-06-28 DOI: 10.3343/kjlm.2011.31.3.143

Kyoung-Jin Park, Eui-Hoon Kwon, Hee-Jin Kim, Sun-Hee Kim

{"title":"Evaluation of the diagnostic performance of fibrin monomer in disseminated intravascular coagulation.","authors":"Kyoung-Jin Park, Eui-Hoon Kwon, Hee-Jin Kim, Sun-Hee Kim","doi":"10.3343/kjlm.2011.31.3.143","DOIUrl":"https://doi.org/10.3343/kjlm.2011.31.3.143","url":null,"abstract":"Background: Fibrin-related markers (FRM) such as fibrin monomer (FM) and D-dimer (DD) are considered useful biological markers for the diagnosis of disseminated intravascular coagulation (DIC). However, no studies on the diagnostic performance of different FRMs have been published in Korea. The aim of this study was to evaluate the diagnostic performance of FM for DIC in comparison with DD.Methods: The reference limit of FM was determined based on plasma sample data obtained from 210 control individuals. To evaluate diagnostic performance, FM data from the plasma samples of 139 patients with DIC-associated diseases were obtained for DIC scoring. FM was measured by immunoturbidimetry using STA-LIATEST FM (Diagnostica Stago, France). Patients were classified according to the DIC score as non-DIC, non-overt DIC, or overt DIC. ROC curve analyses were performed.Results: The reference limit in the control individuals was determined to be 7.80 µg/mL. Patients with DIC-associated diseases were categorized as non-DIC (N=43), non-overt DIC (N=80), and overt DIC (N=16). ROC curve analyses showed that the diagnostic performance of FM was comparable to DD in both non-overt DIC and overt DIC (P=0.596 and 0.553, respectively). In addition, FM had higher sensitivity, specificity, positive predictive value, and negative predictive value than DD for differentiating overt DIC from non-DIC.Conclusions: This study demonstrated that the diagnostic performance of FM for DIC was comparable to DD. FM might be more sensitive and more specific than DD in the diagnosis of overt DIC, but not non-overt DIC.","PeriodicalId":17890,"journal":{"name":"Korean Journal of Laboratory Medicine","volume":"31 3","pages":"143-7"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3343/kjlm.2011.31.3.143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30024249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 20

Erythroleukemia relapsing as precursor B-cell lymphoblastic leukemia. 作为前体b细胞淋巴细胞白血病复发的红白血病。

Korean Journal of Laboratory Medicine Pub Date : 2011-04-01 DOI: 10.3343/kjlm.2011.31.2.81

Borae G Park, Chan-Jeoung Park, Seongsoo Jang, Eul Ju Seo, Hyun-Sook Chi, Jung-Hee Lee

引用次数: 10

Effects of long-term use of depo-medroxyprogesterone acetate on lipid metabolism in Nepalese women. 长期使用醋酸甲羟孕酮对尼泊尔妇女脂质代谢的影响。

Korean Journal of Laboratory Medicine Pub Date : 2011-04-01 DOI: 10.3343/kjlm.2011.31.2.95

Binod Kumar Yadav, Rajesh Kumar Gupta, Prajwal Gyawali, Rojeet Shrestha, Bibek Poudel, Manoj Sigdel, Bharat Jha

{"title":"Effects of long-term use of depo-medroxyprogesterone acetate on lipid metabolism in Nepalese women.","authors":"Binod Kumar Yadav, Rajesh Kumar Gupta, Prajwal Gyawali, Rojeet Shrestha, Bibek Poudel, Manoj Sigdel, Bharat Jha","doi":"10.3343/kjlm.2011.31.2.95","DOIUrl":"https://doi.org/10.3343/kjlm.2011.31.2.95","url":null,"abstract":"Various synthetic progestogens that are used as contraceptives have been reported to influence lipid and lipoprotein fractions differently. Depo-medroxyprogesterone acetate (DMPA), a synthetic progestogen, is used by Nepalese women as a contraceptive agent. Our study aims to determine the effects of long-term use of DMPA on lipid metabolism. We performed this study on 60 healthy Nepalese women who had been using DMPA for more than 2 yr and age- and weight-matched control subjects who were not using hormonal contraceptives. Fasting blood samples were collected from the subjects for the estimation of total cholesterol (TC) and triglyceride (TG) levels, and the levels of high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were estimated using the Friedewald's equation. TC and LDL-C levels in DMPA users were significantly higher than those in non-users. Our study concluded that DMPA use induces lipid metabolism changes that can increase the risk of cardiovascular diseases.","PeriodicalId":17890,"journal":{"name":"Korean Journal of Laboratory Medicine","volume":"31 2","pages":"95-7"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3343/kjlm.2011.31.2.95","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29800473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 20

Streptococcus suis causes septic arthritis and bacteremia: phenotypic characterization and molecular confirmation. 猪链球菌引起脓毒性关节炎和菌血症:表型表征和分子证实。

Korean Journal of Laboratory Medicine Pub Date : 2011-04-01 DOI: 10.3343/kjlm.2011.31.2.115

Hanah Kim, Sang Hoon Lee, Hee-Won Moon, Ji Young Kim, Sun Hwa Lee, Mina Hur, Yeo-Min Yun

{"title":"Streptococcus suis causes septic arthritis and bacteremia: phenotypic characterization and molecular confirmation.","authors":"Hanah Kim, Sang Hoon Lee, Hee-Won Moon, Ji Young Kim, Sun Hwa Lee, Mina Hur, Yeo-Min Yun","doi":"10.3343/kjlm.2011.31.2.115","DOIUrl":"https://doi.org/10.3343/kjlm.2011.31.2.115","url":null,"abstract":"Streptococcus suis is a swine pathogen that causes meningitis, septicemia, pneumonia, and endocarditis. The first case of human S. suis infection was reported in Denmark in 1968, and since then, this infection with has been reported in many countries, especially in Southeast Asia because of the high density of pigs in this region. We report the case of a patient with septic arthritis and bacteremia caused by S. suis. Cases in which S. suis is isolated from the joint fluid are very rare, and to the best of our knowledge, this is first case report of S. suis infection in Korea. The identity of this organism was confirmed by phenotypic characterization and 16S rRNA sequence analysis. An 81-yr-old Korean woman who presented with fever, arthralgia, and headache was admitted to a secondary referral center in Korea. Culture of aspirated joint fluid and blood samples showed the growth of S. suis biotype II, which was identified by the Vitek2 GPI and API 20 Strep systems (bioMérieux, USA), and this organism was susceptible to penicillin G and vancomycin. The 16S rRNA sequences of the blood culture isolates showed 99% homology with those of S. suis subsp. suis, which are reported in GenBank. The patient's fever subsided, and blood and joint cultures were negative for bacterial growth after antibiotic therapy; however, the swelling and pain in her left knee joint persisted. She plans to undergo total knee replacement.","PeriodicalId":17890,"journal":{"name":"Korean Journal of Laboratory Medicine","volume":"31 2","pages":"115-7"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3343/kjlm.2011.31.2.115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29801025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 16

The path to clinical proteomics research: integration of proteomics, genomics, clinical laboratory and regulatory science. 临床蛋白质组学研究之路：蛋白质组学、基因组学、临床实验室和监管科学的整合。

Korean Journal of Laboratory Medicine Pub Date : 2011-04-01 DOI: 10.3343/kjlm.2011.31.2.61

Emily S Boja, Henry Rodriguez

{"title":"The path to clinical proteomics research: integration of proteomics, genomics, clinical laboratory and regulatory science.","authors":"Emily S Boja, Henry Rodriguez","doi":"10.3343/kjlm.2011.31.2.61","DOIUrl":"10.3343/kjlm.2011.31.2.61","url":null,"abstract":"Better biomarkers are urgently needed to cancer detection, diagnosis, and prognosis. While the genomics community is making significant advances in understanding the molecular basis of disease, proteomics will delineate the functional units of a cell, proteins and their intricate interaction network and signaling pathways for the underlying disease. Great progress has been made to characterize thousands of proteins qualitatively and quantitatively in complex biological systems by utilizing multi-dimensional sample fractionation strategies, mass spectrometry and protein microarrays. Comparative/quantitative analysis of high-quality clinical biospecimen (e.g., tissue and biofluids) of human cancer proteome landscape has the potential to reveal protein/peptide biomarkers responsible for this disease by means of their altered levels of expression, post-translational modifications as well as different forms of protein variants. Despite technological advances in proteomics, major hurdles still exist in every step of the biomarker development pipeline. The National Cancer Institute's Clinical Proteomic Technologies for Cancer initiative (NCI-CPTC) has taken a critical step to close the gap between biomarker discovery and qualification by introducing a pre-clinical \"verification\" stage in the pipeline, partnering with clinical laboratory organizations to develop and implement common standards, and developing regulatory science documents with the US Food and Drug Administration to educate the proteomics community on analytical evaluation requirements for multiplex assays in order to ensure the safety and effectiveness of these tests for their intended use.","PeriodicalId":17890,"journal":{"name":"Korean Journal of Laboratory Medicine","volume":"31 2","pages":"61-71"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/d9/kjlm-31-61.PMC3116002.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29799965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New biomarkers of acute kidney injury and the cardio-renal syndrome. 急性肾损伤和心肾综合征的新生物标志物。

Korean Journal of Laboratory Medicine Pub Date : 2011-04-01 DOI: 10.3343/kjlm.2011.31.2.72

Robert Hawkins

{"title":"New biomarkers of acute kidney injury and the cardio-renal syndrome.","authors":"Robert Hawkins","doi":"10.3343/kjlm.2011.31.2.72","DOIUrl":"https://doi.org/10.3343/kjlm.2011.31.2.72","url":null,"abstract":"Changes in renal function are one of the most common manifestations of severe illness. There is a clinical need to intervene early with proven treatments in patients with potentially deleterious changes in renal function. Unfortunately progress has been hindered by poor definitions of renal dysfunction and a lack of early biomarkers of renal injury. In recent years, the definitional problem has been addressed with the establishment of a new well-defined diagnostic entity, acute kidney injury (AKI), which encompasses the wide spectrum of kidney dysfunction, together with clearer definition and sub-classification of the cardio-renal syndromes. From the laboratory have emerged new biomarkers which allow early detection of AKI, including neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C. This review describes the new concepts of AKI and the cardio-renal syndromes as well as novel biomarkers which allow early detection of AKI. Panels of AKI biomarker tests are likely to revolutionize the diagnosis and management of critically ill patients in the coming years. Earlier diagnosis and intervention should significantly reduce the morbidity and mortality associated with acute kidney damage.","PeriodicalId":17890,"journal":{"name":"Korean Journal of Laboratory Medicine","volume":"31 2","pages":"72-80"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3343/kjlm.2011.31.2.72","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29799966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 55

Clinical, pharmacokinetic, and pharmacogenetic determinants of clopidogrel resistance in Korean patients with acute coronary syndrome. 韩国急性冠脉综合征患者氯吡格雷耐药的临床、药代动力学和药物遗传学决定因素。

Korean Journal of Laboratory Medicine Pub Date : 2011-04-01 DOI: 10.3343/kjlm.2011.31.2.91

Kyoung-Jin Park, Hae-Sun Chung, Suk-Ran Kim, Hee-Jin Kim, Ju-Yong Han, Soo-Youn Lee

{"title":"Clinical, pharmacokinetic, and pharmacogenetic determinants of clopidogrel resistance in Korean patients with acute coronary syndrome.","authors":"Kyoung-Jin Park, Hae-Sun Chung, Suk-Ran Kim, Hee-Jin Kim, Ju-Yong Han, Soo-Youn Lee","doi":"10.3343/kjlm.2011.31.2.91","DOIUrl":"https://doi.org/10.3343/kjlm.2011.31.2.91","url":null,"abstract":"Background: Clopidogrel has been widely used to prevent recurrent ischemia in patients with acute coronary syndrome (ACS). However, inter-individual variability in response to clopidogrel has been a problem in the clinical setting. The aim of the present study was to investigate the frequency of clopidogrel resistance and to determine the clinical, pharmacokinetic, and pharmacogenetic factors for clopidogrel resistance in Korean patients with ACS.Methods: Clinical information, such as the underlying diseases and concurrent medications, of 114 patients with ACS who received clopidogrel therapy was studied. The degree of inhibition of platelets was assessed using the VerifyNow assay (Accumetrics, USA). The patients who showed less than 20% inhibition of platelets were defined as non-responders to clopidogrel treatment. Steady state plasma concentrations of clopidogrel were measured using HPLC/tandem mass spectrometry. CYP2C19 genotyping was also performed.Results: A wide inter-individual variability was observed in platelet inhibition (0-76%); 56 patients (49%) showed less than 20% inhibition. There were no differences between the patients' history of diabetes mellitus and concurrent medications as well as the plasma concentrations of clopidogrel of the responders and non-responders. CYP2C19 variants, including CYP2C19*2 and CYP2C19*3, were more commonly observed in the non-responders than in the responders (P value < 0.0001).Conclusions: The response to clopidogrel was highly variable in Korean patients with ACS. The results of the present study confirmed that the genetic polymorphism of CYP2C19 could be important in clopidogrel response. However, further studies are required to investigate other likely factors involved in clopidogrel resistance.","PeriodicalId":17890,"journal":{"name":"Korean Journal of Laboratory Medicine","volume":"31 2","pages":"91-4"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3343/kjlm.2011.31.2.91","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29800472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 23