Clopidogrel pharmacogenetics

Pharmacogenetics of Clopidogrel

Clinical Case A 58-year-old male was presented with an ST-elevation inferior myocardial infarction. Emergency medical services administered 325 mg of aspirin and sublingual nitroglycerin en route to the emergency room. In the emergency room, the patient received 600 mg of clopidogrel and a heparin bolus. Coronary angiography revealed complete occlusion of the distal right coronary artery with t...

clopidogrel pharmacokinetics and pharmacogenetics in iranian patients

Clopidogrel pharmacogenetics: promising steps towards patient care?

Clopidogrel is a pro-drug that requires oxidation to its active metabolite, 2-oxoclopidogrel, by CYP3A4 and other CYP enzymes. This active thiol metabolite inhibits adenosine diphosphate (ADP)-induced platelet aggregation by blocking the platelet P2Y12 receptor (Figure), resulting in 50% reduction in ADP-mediated platelet aggregation. Clopidogrel is standard of care in many patients undergoing ...

Clopidogrel: a case for indication-specific pharmacogenetics.

The CYP2C19*2 loss-of-function allele is associated with reduced generation of active metabolites of clopidogrel. However, meta-analyses have supported or discounted the impact of genotype on adverse cardiovascular outcomes during clopidogrel therapy, depending on studies included in the analysis. Here we review these data and conclude that evidence supports a differential effect of genotype on...

Unraveling the pharmacogenetics of clopidogrel: the paraoxonase-1 controversy.