Clinical outcomes of CYP2C19 genotype-guided antiplatelet therapy: existing evidence and future directions

Pharmacogenomics
Melissa D KleinGeorge A Stouffer

Abstract

It is well established that the CYP2C19 nonfunctional *2 and *3 polymorphisms impair the bioactivation and antiplatelet effects of clopidogrel, and increase the risk of adverse cardiovascular events following percutaneous coronary intervention. In contrast, CYP2C19 genotype does not impact clinical response to prasugrel or ticagrelor. Recent studies have evaluated the impact of CYP2C19 genotype-guided selection of antiplatelet therapy on clinical outcomes and begun to close some of the gaps in knowledge and uncertainty that have impeded widespread clinical implementation of this precision medicine approach. This review will critically evaluate recent data and offer new insight into the potential clinical utility of genotype-guided antiplatelet therapy in the context of current clinical practice guidelines.

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Citations

Jan 21, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Jieyun YouQi Zhang
Jun 24, 2020·Cardiovascular Drugs and Therapy·Jinying ZhouHongbing Yan

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Methods Mentioned

BETA
genotyping

Clinical Trials Mentioned

NCT01742117
NCT01761786
NCT02508116

Software Mentioned

IGNITE
Implementing Genomics in Practice ( IGNITE

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