title: Unveiling the mysteries of clopidogrel metabolism and efficacy.
abstract: Clopidogrel is an important antiplatelet agent, but a considerable variability in the biological effect of the drug has been observed. Additionally, patients with insufficient platelet reactivity inhibition following a loading dose (LD) of clopidogrel have a poor outcome. The mechanisms of variability are dependent on genetic polymorphisms of enzymes involved in clopidogrel metabolism. Paraoxonase 1 has been identified as the main determinant of the biological and clinical efficacy of clopidogrel. This finding could enable the use of pharmacogenomics to tailor antiplatelet agents.
authors.affiliation: Department of Cardiology, Hôpital Universitaire Nord, Faculté de Médecine de Marseille, Marseille, France. laurentbonello@yahoo.fr
authors.forename: L
authors.initials: L
authors.lastname: Bonello
authors.forename: N
authors.initials: N
authors.lastname: Bonello
authors.forename: C
authors.initials: C
authors.lastname: Grosdidier
authors.forename: L
authors.initials: L
authors.lastname: Camoin-Jau
mesh_terms: D043303:Aryldialkylphosphatase / Q000235:genetics*; D002318:Cardiovascular Diseases / Q000235:genetics* / Q000401:mortality*; D005260:Female; D056726:Genetic Association Studies / Q000379:methods*; D014644:Genetic Variation / Q000235:genetics*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000235:genetics*; D011110:Polymorphism, Genetic / Q000235:genetics*; D013988:Ticlopidine / Q000031:analogs & derivatives*
chemical_list: D043303:Aryldialkylphosphatase; D013988:Ticlopidine