RESUMO
AIM: To analyze the influence of pharmacogenetic factors on the risk of clopidogrel resistance and cardiovascular events during 18-months follow-up. SUBJECTS AND METHODS: Two hundred and fifty patients taking clopidogrel were examined. Platelet function was determined by optical aggregometry. Thromboxane A synthase 1 (TBS1) gene polymorphism was investigated in all the patients. The impact of TBS1 gene polymorphism on the risk of clopidogrel resistance and cardiovascular events was analyzed during 18 months of follow-up. RESULTS: The carriage of TBS1 gene polymorphism AA was shown to affect the risk of clopidogrel resistance. Cardiovascular complications significantly less frequently occurred in TBSI gene polymorphism AA carriers during 18 months. CONCLUSION: The carriage of a slow AA allele of the'TBS1 gene is suggested to be a clinically significant protective factor in the secondary prevention of coronary heart disease
Assuntos
Doença das Coronárias/genética , Resistência a Medicamentos/genética , Inibidores da Agregação Plaquetária/uso terapêutico , Tromboxano-A Sintase/genética , Ticlopidina/análogos & derivados , Clopidogrel , Doença das Coronárias/tratamento farmacológico , Doença das Coronárias/metabolismo , Citocromo P-450 CYP2C19/genética , Interpretação Estatística de Dados , Feminino , Frequência do Gene , Humanos , Estimativa de Kaplan-Meier , Masculino , Agregação Plaquetária/efeitos dos fármacos , Inibidores da Agregação Plaquetária/administração & dosagem , Polimorfismo Genético , Prognóstico , Estudos Prospectivos , Risco , Tromboxano-A Sintase/metabolismo , Ticlopidina/administração & dosagem , Ticlopidina/uso terapêuticoRESUMO
OBJECTIVE: To evaluate the efficacy and safety of D-, L-hopantenic acid (pantogam active) on cognitive and anxiety disorders in patients with arterial hypertension. MATERIAL AND METHODS: Autors selected 80 inpatients of a cardiology department with the verified diagnosis of hypertension and comorbid cognitive and anxiety disorders (50 patients in the main group, 30 patients in the control one). All patients received standard cardiotropic hypotensive treatment. Patients of the main group received in addition pantogam active in the daily dose from 600 to 1200 mg. Psychopathological and psychometric examinations were conducted, the data were compared with the dynamics of physical parameters (ECG, ambulatory blood pressure monitoring, blood chemistry). The duration of treatment with pantogam activ was 28 days. RESULTS: There was a significant reduction in both cognitive and anxiety disorders in the main group compared with the controls and in patients with a history of stroke. The positive dynamics was observed during the treatment period. CONCLUSION: Authors support the possibility of using D-, L-hopantenic acid (pantogam active) as a drug of choice with bimodal activity (nootropic and tranquilizing) in the treatment of cognitive and anxiety disorders in patients with arterial hypertension. A rapid (in the first week) significant reduction of cognitive and anxiety disorders during the treatment with pantogam activ was noted.