Pharmacogenetic testing for CYP2C19 polymorphisms is recommended to individualize clopidogrel therapy in patients who exhibit poor response to standard antiplatelet treatment.
May support CYP2C19 testing in clopidogrel poor responders; leaves open need for prospective trials before routine use.
Cerebrovascular and cardiovascular diseases are the worldwide leading causes of mortality. Therefore, therapy of these diseases is of great importance. Antiplatelet therapy with clopidogrel alone and in combination with aspirin has a prominent place. The major problem in clopidogrel therapy is patients' poor response to standard protocols of treatment, followed by increased rate of repeated cardiovascular events. Main cause of the poor response to antiplatelet clopidogrel therapy is pharmacogenomic modification of cytochrome P450 as well as P-glycoprotein, responsible for absorption and bioavailability. Genetic testing is recommended for patients who respond poorly to standard antiplatelet therapy.
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Rančić et al. (2013) studied this question.
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