title: Progress of antiplatelet pharmacogenomics.
abstract: Numerous genetic variants have been studied in the context of antiplatelet responsiveness, particularly for aspirin and clopidogrel. The majority of these variants have failed to demonstrate any measurable level of clinical validity with the exception of the CYP2C19*2 allele. Several studies have identified a link between CYP2C19*2 carriers and decreased clopidogrel responsiveness as assessed by platelet reactivity testing and clinical outcomes. The FDA boxed warning and strong evidence of the CYP2C19*2 allele provide a compelling indication to alter treatment when genotype information is available. However, several questions remain and universal genotyping cannot be recommended at this time without further studies that establish the clinical utility of genomic testing for clopidogrel.
authors: University of Nebraska Medical Center, Department of Pharmacy Practice, College of Pharmacy, Omaha, NE 68198-6045, USA. joestreich@unmc.edu
authors: Julie H
authors: JH
authors: Oestreich
mesh_terms: D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics / Q000378:metabolism; D001711:Biotransformation; D000077144:Clopidogrel; D065731:Cytochrome P-450 CYP2C19; D004351:Drug Resistance; D006801:Humans; D010597:Pharmacogenetics / Q000639:trends*; D010975:Platelet Aggregation Inhibitors / Q000493:pharmacokinetics* / Q000627:therapeutic use; D011110:Polymorphism, Genetic; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000493:pharmacokinetics; D057170:Translational Research, Biomedical
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D013988:Ticlopidine