Association of Cytochrome P450 2C19 Genotype With the Antiplatelet Effect and Clinical Efficacy of Clopidogrel Therapy

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Abstract
Dual antiplatelet therapy, including clopidogrel and aspirin, inhibits platelet function, preventing ischemic events and improving outcomes following acute coronary syndromes and percutaneous coronary intervention (PCI).1,2 To exert an antiplatelet effect, clopidogrel requires conversion to an active thiol metabolite (SR 26334) by hepatic cytochrome P450 (CYP) isoenzymes, which inhibit adenosine diphosphate (ADP)–stimulated platelet activation by irreversibly binding to platelet P2Y12 receptors.3-5