Pharmacokinetic and Pharmacogenetic Predictors of Major Bleeding Events in Patients with an Acute Coronary Syndrome and Atrial Fibrillation Receiving Combined Antithrombotic Therapy
<b>Objective:</b> This study’s objective was to evaluate the effects of pharmacokinetic and pharmacogenetic factors on major bleeding in patients with ACS and non-valvular AF receiving combined antithrombotic therapy consisting of rivaroxaban, clopidogrel, and aspirin as part of dual or...
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MDPI AG
2023-09-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/13/9/1371 |
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| author | Olga Baturina Maria Chashkina Denis Andreev Karin Mirzaev Alexandra Bykova Alexandr Suvorov Daria Yeryshova Svetlana Suchkova Dmitry Sychev Abram Syrkin |
| author_facet | Olga Baturina Maria Chashkina Denis Andreev Karin Mirzaev Alexandra Bykova Alexandr Suvorov Daria Yeryshova Svetlana Suchkova Dmitry Sychev Abram Syrkin |
| author_sort | Olga Baturina |
| collection | DOAJ |
| description | <b>Objective:</b> This study’s objective was to evaluate the effects of pharmacokinetic and pharmacogenetic factors on major bleeding in patients with ACS and non-valvular AF receiving combined antithrombotic therapy consisting of rivaroxaban, clopidogrel, and aspirin as part of dual or triple therapy. <b>Methods:</b> A prospective observational study was conducted in two PCI centers in Moscow, the Russian Federation, from 2017 to 2018. One hundred patients with ACS and AF were enrolled. Prospective follow-ups continued for 12 months. <b>Results:</b> A total of 36 patients experienced bleeding events, with 10 experiencing major bleeding based on the BARC scale and 17 experiencing major bleeding based on the ISTH scale. The following predictors associated with an increased number of major bleeding events were identified: for the ISTH scale, a Css min. of rivaroxaban of >137 pg/mL (5.94 OR, (95% CI, 3.13–12.99; <i>p</i> < 0.004)) and carriage of the T allelic variant polymorphism ABCB1 rs4148738 (8.97 OR (95% CI, 1.48–14.49; <i>p</i> < 0.017)), as well as for the BARC scale (5.76 OR (95% CI, 2.36–9.87; <i>p</i> < 0.018)). <b>Conclusions:</b> Measuring residual steady-state rivaroxaban concentrations and determining the carriage of the T allelic variant polymorphism ABCB1 rs4148738 may be applicable to high-risk patients for subsequent antithrombotic therapy modification. |
| first_indexed | 2024-03-10T22:34:21Z |
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| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-10T22:34:21Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
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| series | Journal of Personalized Medicine |
| spelling | doaj.art-a44e00359c3242a395e8d186cebd68a12023-11-19T11:31:17ZengMDPI AGJournal of Personalized Medicine2075-44262023-09-01139137110.3390/jpm13091371Pharmacokinetic and Pharmacogenetic Predictors of Major Bleeding Events in Patients with an Acute Coronary Syndrome and Atrial Fibrillation Receiving Combined Antithrombotic TherapyOlga Baturina0Maria Chashkina1Denis Andreev2Karin Mirzaev3Alexandra Bykova4Alexandr Suvorov5Daria Yeryshova6Svetlana Suchkova7Dmitry Sychev8Abram Syrkin9Cardiology, Functional and Ultrasound Diagnostics Department, N.V. Sklifosovskiy Institute of Clinical Medicine, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow 119048, RussiaCardiology, Functional and Ultrasound Diagnostics Department, N.V. Sklifosovskiy Institute of Clinical Medicine, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow 119048, RussiaCardiology, Functional and Ultrasound Diagnostics Department, N.V. Sklifosovskiy Institute of Clinical Medicine, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow 119048, RussiaClinical Pharmacology and Therapy Department B.E. Votchal, Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Moscow 125993, RussiaCardiology, Functional and Ultrasound Diagnostics Department, N.V. Sklifosovskiy Institute of Clinical Medicine, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow 119048, RussiaWorld-Class Research Center “Digital Biodesign and Personalized Healthcare”, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow 119048, RussiaCardiology, Functional and Ultrasound Diagnostics Department, N.V. Sklifosovskiy Institute of Clinical Medicine, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow 119048, RussiaCardiology, Functional and Ultrasound Diagnostics Department, N.V. Sklifosovskiy Institute of Clinical Medicine, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow 119048, RussiaClinical Pharmacology and Therapy Department B.E. Votchal, Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Moscow 125993, RussiaCardiology, Functional and Ultrasound Diagnostics Department, N.V. Sklifosovskiy Institute of Clinical Medicine, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow 119048, Russia<b>Objective:</b> This study’s objective was to evaluate the effects of pharmacokinetic and pharmacogenetic factors on major bleeding in patients with ACS and non-valvular AF receiving combined antithrombotic therapy consisting of rivaroxaban, clopidogrel, and aspirin as part of dual or triple therapy. <b>Methods:</b> A prospective observational study was conducted in two PCI centers in Moscow, the Russian Federation, from 2017 to 2018. One hundred patients with ACS and AF were enrolled. Prospective follow-ups continued for 12 months. <b>Results:</b> A total of 36 patients experienced bleeding events, with 10 experiencing major bleeding based on the BARC scale and 17 experiencing major bleeding based on the ISTH scale. The following predictors associated with an increased number of major bleeding events were identified: for the ISTH scale, a Css min. of rivaroxaban of >137 pg/mL (5.94 OR, (95% CI, 3.13–12.99; <i>p</i> < 0.004)) and carriage of the T allelic variant polymorphism ABCB1 rs4148738 (8.97 OR (95% CI, 1.48–14.49; <i>p</i> < 0.017)), as well as for the BARC scale (5.76 OR (95% CI, 2.36–9.87; <i>p</i> < 0.018)). <b>Conclusions:</b> Measuring residual steady-state rivaroxaban concentrations and determining the carriage of the T allelic variant polymorphism ABCB1 rs4148738 may be applicable to high-risk patients for subsequent antithrombotic therapy modification.https://www.mdpi.com/2075-4426/13/9/1371combined antithrombotic therapyrivaroxabanclopidogreldual antiplatelet therapytriple antiplatelet therapyatrial fibrillation |
| spellingShingle | Olga Baturina Maria Chashkina Denis Andreev Karin Mirzaev Alexandra Bykova Alexandr Suvorov Daria Yeryshova Svetlana Suchkova Dmitry Sychev Abram Syrkin Pharmacokinetic and Pharmacogenetic Predictors of Major Bleeding Events in Patients with an Acute Coronary Syndrome and Atrial Fibrillation Receiving Combined Antithrombotic Therapy Journal of Personalized Medicine combined antithrombotic therapy rivaroxaban clopidogrel dual antiplatelet therapy triple antiplatelet therapy atrial fibrillation |
| title | Pharmacokinetic and Pharmacogenetic Predictors of Major Bleeding Events in Patients with an Acute Coronary Syndrome and Atrial Fibrillation Receiving Combined Antithrombotic Therapy |
| title_full | Pharmacokinetic and Pharmacogenetic Predictors of Major Bleeding Events in Patients with an Acute Coronary Syndrome and Atrial Fibrillation Receiving Combined Antithrombotic Therapy |
| title_fullStr | Pharmacokinetic and Pharmacogenetic Predictors of Major Bleeding Events in Patients with an Acute Coronary Syndrome and Atrial Fibrillation Receiving Combined Antithrombotic Therapy |
| title_full_unstemmed | Pharmacokinetic and Pharmacogenetic Predictors of Major Bleeding Events in Patients with an Acute Coronary Syndrome and Atrial Fibrillation Receiving Combined Antithrombotic Therapy |
| title_short | Pharmacokinetic and Pharmacogenetic Predictors of Major Bleeding Events in Patients with an Acute Coronary Syndrome and Atrial Fibrillation Receiving Combined Antithrombotic Therapy |
| title_sort | pharmacokinetic and pharmacogenetic predictors of major bleeding events in patients with an acute coronary syndrome and atrial fibrillation receiving combined antithrombotic therapy |
| topic | combined antithrombotic therapy rivaroxaban clopidogrel dual antiplatelet therapy triple antiplatelet therapy atrial fibrillation |
| url | https://www.mdpi.com/2075-4426/13/9/1371 |
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