Tailoring Antiplatelet Therapy Based on Pharmacogenomics
How Well Do the Data Fit?
- Deepak L. Bhatt, MD, MPH
- Author Affiliations: VA Boston Healthcare System and Brigham and Women's Hospital, Boston, Massachusetts.
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- CARDIOVASCULAR DISEASES
- CLOPIDOGREL
- CORONARY INTERVENTION, PERCUTANEOUS
- CYP2C19 PROTEIN, HUMAN
- CYTOCHROME P-450 ENZYME SYSTEM
- DRUG THERAPY
- GENOMICS
- PERCUTANEOUS CORONARY INTERVENTION
- PHARMACOGENETICS
- PLATELET AGGREGATION INHIBITORS
Antiplatelet therapy has a prominent role in the treatment of a broad range of cardiovascular diseases, and data supporting the role of aspirin in secondary prevention are robust.1 As monotherapy, the thienopyridine clopidogrel has also been shown to have modestly superior efficacy compared with aspirin in secondary prevention for patients with recent myocardial infarction or stroke or with established peripheral arterial disease.2 When given in addition to aspirin, clopidogrel has been demonstrated to have an incremental benefit in patients with acute coronary syndromes, in those undergoing percutaneous coronary intervention (PCI), and most recently, in those who have atrial fibrillation but are not candidates for warfarin.3,4
Variability in response to aspirin and clopidogrel were identified and offered as potential explanations for why some patients had recurrent ischemic events despite taking aspirin and clopidogrel.5,6 In the case of aspirin, much of the apparent “aspirin …
