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Genetic Determinants of Response to Clopidogrel and Cardiovascular Events
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Genetic Determinants of Response to Clopidogrel and Cardiovascular Events
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Journal Article
Genetic Determinants of Response to Clopidogrel and Cardiovascular Events
2009
Overview
In a cohort of 2208 patients who presented with acute myocardial infarction and were treated with clopidogrel, single-nucleotide polymorphisms in five genes known to influence the response to clopidogrel were analyzed. Patients who carried loss-of-function alleles of the gene encoding CYP2C19, as compared with those who did not, had a significantly higher rate of cardiovascular events during the subsequent year.
In patients who presented with acute myocardial infarction and were treated with clopidogrel, those who carried loss-of-function alleles of the gene encoding CYP2C19 had a significantly higher rate of cardiovascular events during the subsequent year.
Dual antiplatelet therapy with aspirin and clopidogrel is currently recommended for the prevention of atherothrombotic events in patients after acute myocardial infarction.
1
,
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However, even with the use of such therapy, a substantial number of subsequent ischemic events still occur.
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–
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There is interindividual variability in the response to clopidogrel.
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–
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Some studies have suggested that hyporesponsiveness is associated with poorer clinical outcomes after an acute coronary syndrome, particularly after percutaneous coronary intervention (PCI).
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However, there is also variability in the identification of biologic hyporesponsiveness to clopidogrel, depending on the test or agonist used and the timing of the assessment. . . .
Publisher
Massachusetts Medical Society
Subject
/ Aged
/ Angioplasty, Balloon, Coronary
/ Aryl Hydrocarbon Hydroxylases - genetics
/ Aryl Hydrocarbon Hydroxylases - metabolism
/ ATP Binding Cassette Transporter, Sub-Family B
/ ATP-Binding Cassette, Sub-Family B, Member 1 - genetics
/ Biological and medical sciences
/ Cytochrome P-450 CYP3A - genetics
/ Female
/ Genotype
/ Humans
/ Kinases
/ Male
/ Mutation
/ Myocardial Infarction - epidemiology
/ Myocardial Infarction - genetics
/ Myocardial Infarction - therapy
/ Platelet Aggregation - drug effects
/ Platelet Aggregation Inhibitors - adverse effects
/ Platelet Aggregation Inhibitors - pharmacology
/ Platelet Aggregation Inhibitors - therapeutic use
/ Receptors, Purinergic P2 - genetics
/ Ticlopidine - adverse effects
