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dc.contributor.authorTselepis, A. D.en
dc.contributor.authorTsoumani, M. E.en
dc.contributor.authorKalantzi, K. I.en
dc.contributor.authorDimitriou, A. A.en
dc.contributor.authorTellis, C.en
dc.contributor.authorGoudevenos, I. A.en
dc.rightsDefault Licence-
dc.subjectacute coronary syndromeen
dc.subjecthigh-density lipoproteinen
dc.subjectfactor-acetylhydrolase activityen
dc.subjectgene polymorphismsen
dc.subjectfibrinogen bindingen
dc.subjectevents. Background: The paraoxonase activity of the enzyme paraoxonase-1 (PON-1) associated with high-density lipoprotein (HDL) may significantly influence clopidogrels antiplatelet and clinical efficacy as a result of its involvement in the clopidogrel biotransformation to the pharmacologically active thiol metabolite. We evaluated the possible relationships of HDL levels as well as PON-1 activities and the Q192R genotype with clopidogrels antiplatelet efficacy in acute coronary syndrome (ACS) patients. Methods and results: The platelet aggregation, P-selectin expression and platelet/leukocyte conjugates as well as the clopidogrel response variability (evaluated by the VASP phosphorylation test and expressed as platelet reactivity index, PRI) were assessed in 74 ACS patients undergoing percutaneous coronary intervention (PCI) in relation to the PON-1 Q192R genotype and to serum HDL-cholesterol levels, and PON-1 (paraoxonase and arylesterase) activities. Patients were loaded with 600 mg of clopidogrel followed by 75 mg per day. HDL-cholesterol levels and PON-1 activities at baseline (before clopidogrel loading) were not altered at 5- and 30-day post-clopidogrel loading, whereas baseline platelet activation parameters were significantly attenuated. At 5 days, 17 patients were clopidogrel non-responders (PRI: 64.2 +/- 11.1%). HDL-cholesterol was inversely associated with platelet activation parameters independently on platelet response variability to clopidogrel whereas a negative association between platelet activation parameters and paraoxonase activity was observed in patients adequately responding to clopidogrel but not in clopidogrel non-responders. Similarly, the platelet activation markers were significantly higher in PON-1 Q192Q genotype carriers compared with those having one or two R alleles only in patients adequately responding to clopidogrel. Conclusions: PON-1 is an important determinant of clopidogrel antiplatelet efficacy only in patients adequately responding to clopidogrel. These findings may be clinically important in ACS patients receiving clopidogrel therapy, especially the first days after the episode.en
dc.titleInfluence of high-density lipoprotein and paraoxonase-1 on platelet reactivity in patients with acute coronary syndromes receiving clopidogrel therapyen
heal.type.enJournal articleen
heal.type.elΆρθρο Περιοδικούel
heal.identifier.primary<Go to ISI>://000298059500005-
heal.identifier.secondaryinternal-pdf://Tselepis-2011-Influence of high-de-3316603151/Tselepis-2011-Influence of high-de.pdf-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Θετικών Επιστημών. Τμήμα Χημείαςel
heal.publisherDOI 10.1111/j.1538-7836.2011.04541.xen
heal.journalNameJournal of Thrombosis and Haemostasisen
heal.journalTypepeer reviewed-
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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