학술논문
P2Y12 Reaction Units and Clinical Outcomes in Acute Large Artery Atherosclerotic Stroke: A Multicenter Prospective Study
Document Type
Journal Article
Author
Eisuke Furui; Haruko Yamamoto; Hiroshi Yamagami; Kazuki Fukuma; Kazunori Toyoda; Kazuo Hashikawa; Kazuyuki Nagatsuka; Kenichi Todo; Kenji Kamiyama; Koichi Kokame; Kunihiro Nishimura; Masafumi Ihara; Masayuki Ezura; Mikito Hayakawa; Ryo Itabashi; Shigeki Miyata; Shinichiro Uchiyama; Tomotaka Tanaka; Toshiyuki Miyata; Yasuhiro Manabe; Yukiko Enomoto; Yuriko Nakaoku
Source
Journal of Atherosclerosis and Thrombosis. 2023, 30(1):39
Subject
Language
English
ISSN
1340-3478
1880-3873
1880-3873
Abstract
Results: Among the 230 AIS/TIA patients enrolled, 225 with complete outcome data and 194 with genetic results were analyzed. A higher PRU was significantly associated with recurrent ischemic stroke within 90 days (frequency, 16%), and within 7 days (10%). Twenty-nine patients (15%) belonged to a CYP2C19 poor metabolizer group (CYP2C19＊2/＊2, ＊2/＊3, or ＊3/＊3). Multivariable receiver-operating characteristic analysis showed a greater area-under-the-curve (AUC) in predicting recurrence within 7 days, compared to 8–90 days (AUC, 0.79 versus 0.64; p=0.07), with a cut-off PRU of 254. Multivariable analysis showed high PRU (≥ 254), which had a comparable predictive performance for recurrent ischemic stroke within 7 days (odds ratio, 6.82; 95% CI, 2.23–20.9; p＜0.001) to the CYP2C19 poor metabolizer genotype. The net reclassification improvement, calculated by adding high PRU (≥ 254) to a model including the CYP2C19 poor metabolizer genotype in the prediction of recurrence within 7 days, was 0.83 (p＜0.001).