Personalized antiplatelet therapy: Review of the latest clinical evidence

被引：11

作者：

Camilleri E. ^{[1
]}

Jacquin L. ^{[2
]}

Paganelli F. ^{[3
]}

Bonello L. ^{[3
]}

机构：

[1] Service de Cardiologie, Hôpital de Martigues, Martigues

[2] Pole Réanimation Urgences, Hôpital Timone, Marseille

[3] Service de Cardiologie, Hôpital Universitaire Nord, 13015 Marseille, Chemin des Bourrely

来源：

Current Cardiology Reports | 2011年 / 13卷 / 4期

关键词：

Acute coronary syndrome; Antiplatelet; Clopidogrel; CYP450; Cytochrome P450; Genes; Genetics; High on-treatment platelet reactivity; P2Y12-ADP receptor antagonist; Percutaneous coronary intervention; Platelet reactivity; Polymorphism; Prasugrel; Stent thrombosis; Therapy; Ticagrelor; Vasodilator-stimulated phosphoprotein; VerifyNow P2Y12 device;

D O I：

10.1007/s11886-011-0194-1

中图分类号：

学科分类号：

摘要：

P2Y12-ADP receptor antagonist use has been critical in the development of percutaneous coronary intervention, dramatically reducing the rate of early stent thrombosis. However, it recently was observed that a significant proportion of patients do not achieve optimal platelet reactivity inhibition after clopidogrel loading dose. The large interindividual variability in clopidogrel responsiveness is related to several factors, including the genetic polymorphism of hepatic cytochrome P450 2C19 (CYP2C19*2), which recently has been highlighted by a warning from the U.S. Food and Drug Administration. Of importance, patients exhibiting reduced clopidogrel metabolism and/or low clopidogrel responsiveness (ie, high ontreatment platelet reactivity) have an increased rate of thrombotic events after percutaneous coronary intervention. This review summarizes the current knowledge on this important clinical issue. While the future of genetic testing remains undetermined, several trials are underway to demonstrate the potential utility of platelet reactivity testing with P2Y12-ADP receptor antagonists. © Springer Science+Business Media, LLC 2011.

引用

页码：296 / 302

页数：6

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