Role of Genetic Polymorphisms in Clopidogrel Response Variability: A Systematic Review.


East Florida


Aventura Hospital and Medical Center

Document Type


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Humans, Clopidogrel, Platelet Aggregation Inhibitors, Cytochrome P-450 CYP2C19, Drug-Eluting Stents, Polymorphism, Genetic


Cardiovascular Diseases | Congenital, Hereditary, and Neonatal Diseases and Abnormalities | Internal Medicine | Medicine and Health Sciences


INTRODUCTION: Clopidogrel is a P2Y

AREAS COVERED: As a prodrug, the metabolism and efficacy of clopidogrel are contingent on the presence of wild-type CYP450 (CYP2C19) alleles. Genetic polymorphisms and variants are well known to impair its ability to prevent major adverse cardiovascular events in these patients, with inadequate response rates as high as 30% in previous publications. Patterns of allelic frequencies are expected to exhibit similarities between individuals of the same ancestry, ethnic group or geographic region. Accordingly, we seek to further elucidate worldwide prevalence rates for genetic polymorphisms in the CYP2C19-dependent metabolism of clopidogrel and review the potential of personalised CYP2C19 genotyping in clinical practice to mitigate this high treatment resistance and its associated burden on patients.

EXPERTS' COMMENTARY: Our findings support the consideration of genotyping before initiation of therapy to guide adequate dosage or substitutions of other P2Y

Publisher or Conference

Open Heart