scispace - formally typeset
Open AccessJournal ArticleDOI

Clinical Pharmacogenetics Implementation Consortium Guidelines for CYP2C19 Genotype and Clopidogrel Therapy: 2013 Update

Reads0
Chats0
TLDR
In this article, an expanded literature review showed that 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).
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).

read more

Citations
More filters
Journal ArticleDOI

Preemptive Clinical Pharmacogenetics Implementation: Current Programs in Five US Medical Centers

TL;DR: Current programs that use preemptive genotyping to optimize the pharmacotherapy of patients are discussed and key processes for implementation are highlighted, including clinical decision support.
References
More filters
Journal ArticleDOI

Genetic polymorphisms of CYP2C19 influences the response to clopidogrel in ischemic heart disease patients in the South Indian Tamilian population.

TL;DR: Patients with CYP2C19 (*2 or *3) genetic polymorphisms had higher residual platelet activities and were associated with a reduced antiplatelet response to clopidogrel, and these findings mandate further studies aimed at initiating genome-based personalized antiplatelets therapy.
Journal ArticleDOI

Relation of CYP2C19 loss-of-function polymorphism to the occurrence of stent thrombosis.

TL;DR: A review of the principal studies contributing to establish the relationship between CYP2C19*2 polymorphism and adverse outcomes in high risk patients on clopidogrel treatment concludes that prospective studies are urgently needed to determine the clinical impact of a score that takes into account individual characteristics of patients.
Journal ArticleDOI

Cytochrome P450 2C19 Polymorphism, Suboptimal Reperfusion and All-Cause Mortality in Patients with Acute Myocardial Infarction

TL;DR: The CYP2C19*2 allele is an independent predictor of suboptimal reperfusion in patients with AMI undergoing PCI with stenting after pretreatment with clopidogrel and may increase the risk of all-cause mortality.
Journal ArticleDOI

CYP2C19*2/ABCB1-C3435T polymorphism and risk of cardiovascular events in coronary artery disease patients on clopidogrel: Is clinical testing helpful?

TL;DR: In CAD patients on clopidogrel therapy, CYP2C19*2 polymorphism is associated with significantly increased adverse cardiovascular events, however, due to the low positive predictive value, routine genetic testing cannot be recommended at present.
Journal ArticleDOI

High on-treatment platelet reactivity by ADP and increased risk of MACE in good clopidogrel metabolizers

TL;DR: Both phenotype and genotype are clinically relevant for the evaluation of the antiplatelet effect of clopidogrel and for the prognostic stratification of ACS patients.
Related Papers (5)