title: CYP2C19 and clopidogrel response: more than validation in the real world.
abstract: Electronic health records (EHRs) coupled to DNA biobanks are potentially powerful but untested resources for pharmacogenomic discoveries. As described in this issue, Delaney and co-workers validated the use of EHRs by demonstrating that loss-of-function CYP2C19*2 was associated with poorer cardiovascular outcomes in clopidogrel-treated patients with an effect size similar to that reported in more controlled clinical trials. Whether studies from real-world EHR-biobanks will supplant randomized clinical trials to provide a sufficient evidence base to change practice is less certain.
authors.affiliation: Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA. ashuldin@medicine.umaryland.edu
authors.forename: A R
authors.initials: AR
authors.lastname: Shuldiner
mesh_terms: D000077144:Clopidogrel; D030561:Databases, Nucleic Acid; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy*; D010597:Pharmacogenetics / Q000379:methods*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013927:Thrombosis / Q000188:drug therapy*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine