Clinical Pharmacogenetics Implementation Consortium Guidelines forCYP2C19Genotype and Clopidogrel Therapy: 2013 Update

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Abstract

Cytochrome P450 (CYP)2C19 catalyzes the bioactivation of the antiplatelet prodrug clopidogrel, andCYP2C19loss-of-function alleles impair formation of active metabolites, resulting in reduced platelet inhibition. In addition,CYP2C19loss-of-function alleles confer increased risks for serious adverse cardiovascular (CV) events among clopidogreltreated patients with acute coronary syndromes (ACSs) undergoing percutaneous coronary intervention (PCI). Guideline updates include emphasis on appropriate indication forCYP2C19genotype-directed antiplatelet therapy, refined recommendations for specificCYP2C19alleles, and additional evidence from an expanded literature review (updates athttp://www.pharmgkb.org).

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