Effects of cigarette smoking on older chinese men treated with clopidogrel monotherapy or aspirin monotherapy: a prospective study

Cai, Yingying; Xu, Weihao; Wang, Fan; Duan, Lijun; Li, Huiying; Li, Man; Li, Yuerui; Han, Lina; Xiao, Hunan

doi:10.1080/09537104.2019.1667494

“…Previous studies concluded that smoking incudes enzyme activation of cytochrome P450 (primarily 2B6 and 1A2 isoenzymes), which are crucial for the biotransformation of the medication clopidogrel. 5,13 Smoking increases clopidogrel's anti-aggregative action and platelet inhibition since it speeds up the drug's metabolism. Platelet P2Y 12 receptors may become more numerous and expressed when exposed to nicotine, which may improve their sensitivity to clopidogrel.…”

Section: Discussionmentioning

confidence: 99%

“…Platelet P2Y 12 receptors may become more numerous and expressed when exposed to nicotine, which may improve their sensitivity to clopidogrel. 5,13 Clopidogrel should be the drug of choice when it comes to long term prevention of CVD disease in smoker patients because of the larger number of clopidogrel responders and aspirin non-responders. 14 This is especially important for patients who, in accordance with recommended practices, depend on a single antiplatelet therapy, typically aspirin, for their protection against the development of atherosclerosis and do not have a clinical rationale for a combined antiplatelet treatment in combination with clopidogrel.…”

Section: Discussionmentioning

confidence: 99%

The impact of smoking status on clopidogrel responsiveness in patients with coronary artery disease who undergo percutaneous coronary intervention

Aldallal¹,

Mohammad

²

,

Rgeeb

³

et al. 2023

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Background: Previous studies have pointed out the disproportionate action of clopidogrel in inhibiting platelet aggregation due to smoking more than ten cigarettes per a day. This study was designed to examine whether smoking enhances clopidogrel responsiveness in patients who are clinically diagnosed with coronary artery disease (CAD), following percutaneous coronary intervention (PCI). Methods: A total of 324 IHD participants were enrolled in a case-control study. Platelet function test was performed to all participants two hours before PCI procedure to measure clopidogrel response. Participants were then categorized into a non-responder group (case group n = 111) and responder group (control group n = 213). Each group was subdivided into a smoker group and a non-smoker group. All participants received clopidogrel loading dose equivalent to 600 mg and scheduled for elective PCI. Participants’ age, gender, family history of chronic illnesses was recorded in this study. Results: Smoking participants displayed a significant higher level of hemoglobin as compared to the non-smoking participants among the responder and the non-responder study groups (14.6±0.55 vs. 13.12±0.38, P < 0.029; 14.3±0.31 versus 12.96±0.39, P < 0.033) but lower AUC level (17±9 vs. 45±6, P < 0.005; 62±3 vs. 95±7, P < 0.008). Additionally, smoking intensity enhanced clopidogrel responsiveness by odd’s ratio 0.4213 at 95% C.I. (0.259 - 0.684), P < 0.0002. Conclusions: Current smokers had a good response to clopidogrel therapy which exerted a beneficial effect when undergoing PCI as compared to non-smokers. The marked difference in AUC between smokers and non-smokers could be related to the variance in hemoglobin level. The smokers’ paradox needs further justification to confirm this concept.

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“…Previous studies concluded that smoking incudes enzyme activation of cytochrome P450 (primarily 2B6 and 1A2 isoenzymes), which are crucial for the biotransformation of the medication clopidogrel. 10,18 Smoking increases clopidogrel's anti-aggregative action and platelet inhibition since it speeds up the drug's metabolism. Platelet P2Y 12 receptors may become more numerous and expressed when exposed to nicotine, which may improve their sensitivity to clopidogrel.…”

Section: Discussionmentioning

confidence: 99%

The impact of smoking status on clopidogrel responsiveness in patients with coronary artery disease who undergo percutaneous coronary intervention

Aldallal,

Mohammad,

Rgeeb

et al. 2023

F1000Res

0

View full text Add to dashboard Cite

Background: Previous studies have pointed out the disproportionate action of clopidogrel in inhibiting platelet aggregation due to smoking more than ten cigarettes per a day. This study was designed to examine whether smoking enhances clopidogrel responsiveness in patients who are clinically diagnosed with coronary artery disease (CAD), following percutaneous coronary intervention (PCI). Methods: A total of 324 IHD participants were enrolled in a case-control study. Platelet function test was performed to all participants two hours before PCI procedure to measure clopidogrel response. Participants were then categorized into a non-responder group (case group n = 111) and responder group (control group n = 213). Each group was subdivided into a smoker group and a non-smoker group. All participants received clopidogrel loading dose equivalent to 600 mg and scheduled for elective PCI. Participants’ age, gender, family history of chronic illnesses was recorded in this study. Results: Smoking participants displayed a significant higher level of hemoglobin as compared to the non-smoking participants among the responder and the non-responder study groups (14.6±0.55 vs. 13.12±0.38, P < 0.029; 14.3±0.31 versus 12.96±0.39, P < 0.033) but lower AUC level (17±9 vs. 45±6, P < 0.005; 62±3 vs. 95±7, P < 0.008). Additionally, smoking intensity enhanced clopidogrel responsiveness by odd’s ratio 0.4213 at 95% C.I. (0.259 - 0.684), P < 0.0002. Conclusions: Current smokers had a good response to clopidogrel therapy which exerted a beneficial effect when undergoing PCI as compared to non-smokers. The marked difference in AUC between smokers and non-smokers could be related to the variance in hemoglobin level. The smokers’ paradox needs further justification to confirm this concept.

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“…Cigarette smoking has appreciable adverse effects on hemorheological parameters, plasma osmolality, and high 5 BioMed Research International fibrinogen level. RBC aggregation in smokers promotes endothelial dysfunction through arterial wall inflammation and the impact of hematocrit on the blood vessel, and the increased blood viscosity may play an adverse role in the dissolution of thrombus [28]. Brain natriuretic peptide precursor is secreted by the cardiac ventricles, increasing serum levels correlate with the severity of left ventricle dysfunction.…”

Section: Discussionmentioning

confidence: 99%

A Novel Clinical Nomogram to Predict Transient Symptomatic Associated with Infarction: The ABCD3-SLOPE Score

Lu

¹

,

Bi

²

,

Wang

³

et al. 2021

BioMed Research International

0

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Background. It is hard to differentiate transient symptoms associated with infarction (TSI) from transient ischemic stroke (TIA) without MRI in the early onset. However, they have distinct clinical outcomes and respond differently to therapeutics. Therefore, we aimed to develop a risk prediction model based on the clinical features to identify TSI. Methods. We enrolled 230 consecutive patients with transient neurologic deficit in the Department of Neurology, Tongji University Affiliated Tenth People’s Hospital from March 2014 to October 2019. All the patients were assigned into TIA group (DWI-negative) or TSI group (DWI-positive) based on MRI conducted within five days of onset. We summarized the clinical characteristics of TSI by univariate and multivariate analyses. And then, we developed and validated a nomogram to identify TSI by the logistic regression equation. Results. Of the 230 patients, 41.3% were diagnosed with TSI. According to the multivariate analysis, four independent risk factors, including smoking history, low-density lipoprotein cholesterol, brain natriuretic peptide precursor, and ABCD3 score, were incorporated into a nomogram. We developed a predictive model named ABCD3-SLOPE. The calibration curve showed good agreement between nomogram prediction and observation. The concordance index (C-index) of the nomogram for TSI prediction was 0.77 (95% confidence interval, 0.70-0.83), and it was well-calibrated. Conclusions. Smoking history, low-density lipoprotein cholesterol, brain natriuretic peptide precursor, and ABCD3 score were reliable risk factors for TSI. ABCD3-SLOPE was a potential tool to quantify the likelihood of TSI.

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Effects of cigarette smoking on older chinese men treated with clopidogrel monotherapy or aspirin monotherapy: a prospective study

Cited by 5 publications

References 40 publications

The impact of smoking status on clopidogrel responsiveness in patients with coronary artery disease who undergo percutaneous coronary intervention

The impact of smoking status on clopidogrel responsiveness in patients with coronary artery disease who undergo percutaneous coronary intervention

The impact of smoking status on clopidogrel responsiveness in patients with coronary artery disease who undergo percutaneous coronary intervention

A Novel Clinical Nomogram to Predict Transient Symptomatic Associated with Infarction: The ABCD3-SLOPE Score

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