Therapy with clopidogrel based on CYP2C19 genotype

Abstract

Introduction. Combined therapy, clopidogrel plus aspirin, prevents secondary thrombotic in acute coronary syndromes (ACS), after percutaneous coronary interventions (PCI) with placement of a coronary artery stent. Clopidogrel is activated in the liver by cytochrome P450 enzymes. CYP2C19 is the principal enzyme. The most common loss-of-function variant is CYP2C19*2. This contributes to the decrease in the active metabolite of clopidogrel in the blood and reduce the effectiveness of clopidogrel therapy.