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      Personalizing antiplatelet prescribing using genetics for patients undergoing percutaneous coronary intervention

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          Abstract

          Introduction

          Clopidogrel is commonly prescribed with aspirin to reduce the risk for adverse cardiovascular events after percutaneous coronary intervention (PCI). However, there is significant inter-patient variability in clopidogrel response. The CYP2C19 enzyme is involved in the biotransformation of clopidogrel to its pharmacologically active form, and variation in the CYP2C19 gene contributes to clopidogrel response variability.

          Areas covered

          This article describes the impact of CYP2C19 genotype on clopidogrel pharmacokinetics, pharmacodynamics, and effectiveness. Examples of clinical implementation of CYP2C19 genotype-guided antiplatelet therapy for patients undergoing PCI are also described as are emerging outcomes data with this treatment approach.

          Expert commentary

          A large clinical trial evaluating outcomes with CYP2C19 genotype-guided anti-platelet therapy after PCI is on-going. In the meantime, data from pragmatic and observational studies and smaller trials support improved outcomes with genotyping after PCI and use of alternative antiplatelet therapy in patients with a CYP2C19 genotype associated with reduced clopidogrel effectiveness.

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          Author and article information

          Contributors
          Journal
          101182328
          31840
          Expert Rev Cardiovasc Ther
          Expert Rev Cardiovasc Ther
          Expert review of cardiovascular therapy
          1477-9072
          1744-8344
          28 September 2017
          19 July 2017
          August 2017
          01 August 2018
          : 15
          : 8
          : 581-589
          Affiliations
          Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida College of Pharmacy, Gainesville, FL, USA
          Author notes
          CONTACT: Larisa H. Cavallari, lcavallari@ 123456cop.ufl.edu , Center for Pharmacogenomics, Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, FL 32610-0486, USA
          Article
          PMC5628391 PMC5628391 5628391 nihpa909323
          10.1080/14779072.2017.1355236
          5628391
          28699807
          b35e7490-3613-4ee1-ba02-266e2ec764b0
          History
          Categories
          Article

          genotype,cardiovascular events,polymorphism,ticagrelor,prasugrel,clopidogrel,CYP2C19,Percutaneous coronary intervention

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