title: Cigarette smoking and clopidogrel interaction.
abstract: Dual antiplatelet therapy (DAPT) with aspirin and an adenosine diphosphate receptor antagonist is central to the modern management of acute coronary syndromes and percutaneous revascularization. The most widely used adenosine diphosphate receptor antagonist, clopidogrel therapy is limited by inter-individual variability in platelet inhibition. Recent data suggest a potential role of smoking in the metabolism of clopidogrel and high on-treatment platelet reactivity. Pharmacodynamic studies and post-hoc analyses of large clinical trials support a link between smoking status and the efficacy of clopidogrel therapy. The mechanism of the interaction between smoking status and clopidogrel efficacy remains unclear but may be mediated by cytochrome P450 (CYP)1A2. There is less evidence available on the influence of smoking status on platelet reactivity and clinical outcomes during prasugrel and ticagrelor therapy.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Kristopher J
authors.initials: KJ
authors.lastname: Swiger
authors.forename: Omair
authors.initials: O
authors.lastname: Yousuf
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Bliden
authors.forename: Udaya S
authors.initials: US
authors.lastname: Tantry
authors.forename: Paul A
authors.initials: PA
authors.lastname: Gurbel
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy / Q000378:metabolism*; D001792:Blood Platelets / Q000187:drug effects; D000077144:Clopidogrel; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000493:pharmacokinetics* / Q000494:pharmacology / Q000627:therapeutic use; D058921:Purinergic P2Y Receptor Antagonists / Q000493:pharmacokinetics* / Q000494:pharmacology / Q000627:therapeutic use; D012907:Smoking / Q000378:metabolism*; D016540:Smoking Cessation; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D000077144:Clopidogrel; D013988:Ticlopidine