Abstract
CYP2C19 is one of the principal enzymes involved in the bioactivation of the antiplatelet prodrug clopidogrel. A common loss-of-function allele, CYP2C19*2 (c.681G>A; rs4244285), is associated with increased risk for serious adverse cardiovascular events in both heterozygous and homozygous patients (~25–50% of the population) with acute coronary syndromes (ACSs) who are receiving clopidogrel, particularly among those undergoing percutaneous coronary intervention (PCI). We provide evidence from published literature and guidelines for CYPC19 genotype–directed antiplatelet therapy (periodically updated at http://www.pharmgkb.org).
Publication types
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Practice Guideline
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Research Support, N.I.H., Extramural
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Review
MeSH terms
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Acute Coronary Syndrome / therapy
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Alleles
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Angioplasty, Balloon, Coronary / methods
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Aryl Hydrocarbon Hydroxylases / genetics*
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Aryl Hydrocarbon Hydroxylases / metabolism
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Clopidogrel
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Cytochrome P-450 CYP2C19
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Genotype
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Humans
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Pharmacogenetics / methods*
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Platelet Aggregation Inhibitors / adverse effects
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Platelet Aggregation Inhibitors / metabolism
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Platelet Aggregation Inhibitors / therapeutic use*
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Ticlopidine / adverse effects
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Ticlopidine / analogs & derivatives*
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Ticlopidine / metabolism
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Ticlopidine / therapeutic use
Substances
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Platelet Aggregation Inhibitors
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Clopidogrel
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Aryl Hydrocarbon Hydroxylases
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CYP2C19 protein, human
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Cytochrome P-450 CYP2C19
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Ticlopidine