title: [Genetic variability in the efficacy of clopidogrel].
abstract: Hepatic cytochrome P450 (CYP) bioactivation of clopidogrel is reduced in subjects with the CYP2C19*2 loss-of-function allele. This allele has been linked to an increased risk of stent thrombosis after percutaneous coronary intervention. In contrast to clopidogrel, the effect of newer antiplatelet agents, e.g., prasugrel and ticagrelor, is not dependent on CYP2C19. This review briefly outlines the current evidence for the value of CYP2C19 genotyping to guide antiplatelet therapy with clopidogrel. Prospective trials of new treatment algorithms are awaited before routine adoption of CYP2C19 genotyping for this purpose.
authors.affiliation: Hjertemedicinsk Afdeling, Gentofte Hospital, Niels Andersens Vej 65, 2900 Hellerup, Denmark.
authors.forename: Karl Emil
authors.initials: KE
authors.lastname: Kristensen
authors.forename: Henrik Berg
authors.initials: HB
authors.lastname: Rasmussen
authors.forename: Peter Riis
authors.initials: PR
authors.lastname: Hansen
mesh_terms: D000483:Alleles; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics*; D000077144:Clopidogrel; D065731:Cytochrome P-450 CYP2C19; D005838:Genotype; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D010597:Pharmacogenetics; D010974:Platelet Aggregation / Q000187:drug effects / Q000235:genetics*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000494:pharmacology*; D058921:Purinergic P2Y Receptor Antagonists / Q000009:adverse effects / Q000494:pharmacology*; D015607:Stents / Q000009:adverse effects; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D000077144:Clopidogrel; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D013988:Ticlopidine