P Berdagué

Publications (6)13.3 Total impact

• Source

  Available from: Michela C Rebsamen

  Article: Relationship between paraoxonase-1 activity, its Q192R genetic variant and clopidogrel responsiveness in the ADRIE study.

  P Fontana, R James, I Barazer, P Berdagué, J-F Schved, M Rebsamen, N Vuilleumier, J-L Reny
  Journal of Thrombosis and Haemostasis 06/2011; 9(8):1664-6. · 5.73 Impact Factor
• Article: Clinical predictors of dual aspirin and clopidogrel poor responsiveness in stable cardiovascular patients from the ADRIE study.

  P Fontana, P Berdagué, C Castelli, S Nolli, I Barazer, P Fabbro-Peray, J-F Schved, H Bounameaux, F Mach, P DE Moerloose, J-L Reny
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  ABSTRACT: Poor response to both aspirin and clopidogrel (dual poor responsiveness [DPR]) is a major risk factor for recurrent ischemic events. The aim of this study was to identify factors associated with DPR, defined with specific tests, and derive a predictive clinical score. We studied 771 consecutive stable cardiovascular patients treated with aspirin (n = 223), clopidogrel (n = 111), or both drugs (n = 37). Aspirin responsiveness was evaluated by serum thromboxane (Tx)B₂ assay, and clopidogrel responsiveness by calculating the platelet reactivity index (PRI) on the basis of the phosphorylation status of the vasodilator phosphoprotein. The analysis was focused on patients treated with both drugs, and on independent predictors of DPR. Among patients on dual therapy, there was no relevant correlation between TxB₂ levels and PRI values (r = 0.11). Sixty-seven patients (15.4%) had DPR. Diabetes [odds ratio (OR) 1.89, 95% confidence interval (CI) 1.06-3.39], high body weight (> 86 kg vs. < 77 kg, OR 4.74, 95% CI 2.49-9.73), low aspirin dose (75-81 mg vs. ≥ 160 mg, OR 0.12, 95% CI 0.09-0.93) and high C-reactive protein (CRP) level (> 1.6 mg L⁻¹ vs. < 0.6 mg L⁻¹, OR 3.66, 95% CI 1.74-8.72) were independently associated with DPR, via increased TxB(2) levels, increased PRI, or both. These associations with TxB₂ and PRI were reproduced across the whole population. With use of a factor-weighed score (c-index = 0.74), the predicted prevalence of DPR was 57% in the highest strata of the score as compared with < 4% for the lowest strata. Diabetes, body weight, the aspirin dose and CRP levels are readily available independent predictors of DPR, and some are potential targets for reducing its prevalence.
  Journal of Thrombosis and Haemostasis 12/2010; 8(12):2614-23. · 5.73 Impact Factor
• Article: [Antiplatelet agents: which one, when and for whom?].

  J-L Reny, A Zufferey, P Berdagué, P Fontana
  La Revue de Médecine Interne 10/2010; 31 Suppl 3:S339-41. · 0.61 Impact Factor
• Article: [The concept of aspirin "resistance": mechanisms and clinical relevance].

  J-L Reny, R F Bonvini, I Barazer, P Berdagué, P de Moerloose, J-F Schved, J-C Gris, P Fontana
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  ABSTRACT: Aspirin, a 110-year-old molecule, is a cornerstone in the treatment of atherothrombotic patients. The concept of aspirin "resistance" emerged approximately 15 years ago and is of growing interest. Aspirin resistance, defined as a lack of inhibition of cyclo-oxygenase-1 (COX-1), is a rare phenomenon and its clinical relevance can hardly be studied. On the contrary, residual platelet hyperactivity is more common and affects 20 to 30% of aspirin-treated patients. This latter phenomenon corresponds to sustained platelet reactivity despite a proper inhibition of COX-1 by aspirin. Several meta-analyses suggest that residual platelet hyperactivity could be a risk factor for the recurrence of ischemic events in aspirin-treated patients. Causes of biological non-responsiveness to aspirin are discussed, including the role of compliance, drug-drug interactions, genetic polymorphisms and diabetes mellitus. Ongoing studies are designed to find out the mechanisms of residual platelet hyperactivity, determine its potential clinical relevance and delineate the more appropriate assays in order to identify patients who may benefit of a tailored antiplatelet therapy.
  La Revue de Médecine Interne 08/2009; 30(12):1020-9. · 0.61 Impact Factor
• Article: [Haemostasis. Aspirin and clopidogrel platelet resistances].

  P Fontana, P Berdagué, J L Reny
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  ABSTRACT: Articles on antiplatelet "resistance" or "nonresponder" subjects now appear in the medical literature or in the media on a regular basis. The clinical consequences of such biological resistances are yet uncertain. In this review, we describe the concepts of specific and non specific resistances according to the tests used and summarize the main studies up to now. If antiplatelet drug resistances are shown to be predictive of cardiovascular events in large prospective studies, tailoring antiplatelet drugs could be beneficial and, therefore, warranted. New compounds with a more potent effect are emerging and might be useful in clinically relevant resistances.
  Revue médicale suisse 02/2006; 2(47):25-9.
• Article: [Chronic obliterative arterial disease of the lower limbs in the coronary patient: prevalence and prognostic incidence. The Monica Toulouse register].

  P Léger, J Ferrières, P Cantié, J P Cambou, J B Ruidavets, P Tarabbia, P Berdagué, H Boccalon
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  ABSTRACT: This study was aimed at evaluating the prevalence of peripheral arterial disease of the lower extremities and its prognostic value in a population of patients from the Haute-Garonne department, who were hospitalized for acute coronary artery disease. Between 1985 and 1991, four thousands three hundred and sixty-eight patients (3,680 males and 688 females) presenting with acute coronary artery disease were included in the study. The prevalence of peripheral arterial disease of the lower extremities was 13.4%, increasing with age and being higher in male patients. In regard to patients hospitalized for acute myocardial infarction (n = 2,417), independent relationships were observed between the 28-day mortality and the following: patient's age (odds ratio: 1.02; 95% confidence interval: 1.01-1.04; P < 0.0005), female gender (odds ratio: 1.32; 95% confidence interval: 1.17-1.54; P < 0.002), inclusion in the study (odds ratio 0.95; 95% confidence interval: 0.90-0.99; P < 0.02), previous coronary artery disease (odds ratio: 2.88; 95% confidence interval: 2.32-3.48; P < 0.0001), and peripheral arterial disease (odds ratio: 1.61; 95% confidence interval: 1.26-2.06; P < 0.0001). The prevalence of peripheral arterial disease of the lower extremities is high in patients with acute coronary artery disease in both genders, whatever the age. This disease is therefore an independent marker of mortality for acute myocardial infarction. Easy diagnosis of peripheral arterial disease of the lower limbs by measurement of the ankle pressure index allows identification of patients prone to death from acute myocardial infarction.
  La Revue de Médecine Interne 05/1999; 20(5):404-7. · 0.61 Impact Factor