Why the study?
Wide variability in clopidogrel response due to genetic factors remains a significant cardiology problem associated with an increased risk of thrombotic complications.
Does a personalized approach to the selection of P2Y12 receptor inhibitors based on pharmacogenetics improve efficacy and reduce thrombotic complications compared to standard clopidogrel therapy?
Does a personalized approach to the selection of P2Y12 receptor inhibitors based on pharmacogenetics improve efficacy and reduce thrombotic complications compared to standard clopidogrel therapy?
Genotype-guided selection of P2Y12 inhibitors, specifically using ticagrelor or prasugrel for CYP2C19 intermediate and poor metabolizers, is a clinically validated strategy to reduce thrombotic risk.
Supports genotype-guided P2Y12 selection in CYP2C19 LOF carriers; confirms clinical utility of pharmacogenetic testing for antiplatelet therapy.
Introduction The wide variability in response to clopidogrel, due to genetic factors, remains a significant problem in cardiology and is associated with an increased risk of thrombotic complications. Objective To summarize current data on the pharmacogenetics of P2Y12 receptor inhibitors and assess the clinical significance of a personalized approach to their prescription. Materials and Methods An analysis of key publications from the PubMed database as well as current clinical guidelines from the ESC and CPIC, was conducted. Results: Carriage of loss-of-function alleles of the CYP2C19 gene (*2, *3) is a key prognostic factor for reduced efficacy of clopidogrel and increased risk of thrombotic events. In patients with intermediate (IM) and poor metabolizer (PM) phenotypes, therapy with ticagrelor or prasugrel demonstrates superiority over clopidogrel. Clinically validated algorithms for selecting antiplatelet agents based on genotyping have been developed.
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N. et al. (2026) conducted a review in Patients requiring P2Y12 receptor inhibitors. Ticagrelor or prasugrel (genotype-guided) vs. Clopidogrel was evaluated.
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