title: Clinical Pharmacogenetics Implementation Consortium guidelines for CYP2C19 genotype and clopidogrel therapy: 2013 update.
abstract: Cytochrome P450 (CYP)2C19 catalyzes the bioactivation of the antiplatelet prodrug clopidogrel, and CYP2C19 loss-of-function alleles impair formation of active metabolites, resulting in reduced platelet inhibition. In addition, CYP2C19 loss-of-function alleles confer increased risks for serious adverse cardiovascular (CV) events among clopidogrel-treated patients with acute coronary syndromes (ACSs) undergoing percutaneous coronary intervention (PCI). Guideline updates include emphasis on appropriate indication for CYP2C19 genotype-directed antiplatelet therapy, refined recommendations for specific CYP2C19 alleles, and additional evidence from an expanded literature review (updates at http://www.pharmgkb.org).
authors.affiliation: Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Scott
authors.forename: K
authors.initials: K
authors.lastname: Sangkuhl
authors.forename: C M
authors.initials: CM
authors.lastname: Stein
authors.forename: J-S
authors.initials: JS
authors.lastname: Hulot
authors.forename: J L
authors.initials: JL
authors.lastname: Mega
authors.forename: D M
authors.initials: DM
authors.lastname: Roden
authors.forename: T E
authors.initials: TE
authors.lastname: Klein
authors.forename: M S
authors.initials: MS
authors.lastname: Sabatine
authors.forename: J A
authors.initials: JA
authors.lastname: Johnson
authors.forename: A R
authors.initials: AR
authors.lastname: Shuldiner
mesh_terms: D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics*; D000077144:Clopidogrel; D065731:Cytochrome P-450 CYP2C19; D005820:Genetic Testing; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000493:pharmacokinetics* / Q000627:therapeutic use; D018570:Risk Assessment; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D013988:Ticlopidine