Does platelet reactivity and genotype testing improve outcomes in patients with ACS and PCI treated with clopidogrel?
The clinical utility of platelet reactivity and genotype testing to guide clopidogrel therapy in ACS and PCI remains unproven.
C lopidogrel is the second-leading drug sold worldwide, yet 13 years and millions of patients treated later, we are just beginning to understand the complexity of its metabolism and antiplatelet effects. 2] Given the central role of clopidogrel in the management of acute coronary syndrome (ACS) and percutaneous coronary intervention (PCI), physicians and regulatory bodies are tackling how best to integrate these data to guide patient care. These efforts are fueled by the motivation to identify people at risk of developing adverse outcomes on clopidogrel, to develop more precise estimates about prognosis, and to fine-tune treatment selection, thereby approaching a form of tailored or personalized medicine.
Krishna et al. (2012) studied this question.