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Annual Review of Pharmacology and Toxicology

Volume 63, 2023

Pharmacogenetics of Antiplatelet Therapy

Abstract

Antiplatelet therapy is used in the treatment of patients with acute coronary syndromes, stroke, and those undergoing percutaneous coronary intervention. Clopidogrel is the most widely used antiplatelet P2Y12 inhibitor in clinical practice. Genetic variation in may influence its enzymatic activity, resulting in individuals who are carriers of loss-of-function alleles and thus have reduced active clopidogrel metabolites, high on-treatment platelet reactivity, and increased ischemic risk. Prospective studies have examined the utility of genetic testing to guide antiplatelet therapy, and more recently published meta-analyses suggest that pharmacogenetics represents a key treatment strategy to individualize antiplatelet therapy. Rapid genetic tests, including bedside genotyping platforms that are validated and have high reproducibility, are available to guide selection of P2Y12 inhibitors in clinical practice. The aim of this review is to provide an overview of the background and rationale for the role of a guided antiplatelet approach to enhance patient care.

Keyword(s): CYP2C19, dual antiplatelet therapy, guided antiplatelet therapy, pharmacogenetics, pharmacogenomics, precision medicine
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/content/journals/10.1146/annurev-pharmtox-051921-092701
2023-01-20
2024-04-27
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/content/journals/10.1146/annurev-pharmtox-051921-092701
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Pharmacogenetics of Antiplatelet Therapy
Annual Review of Pharmacology and Toxicology 63, 211 (2023); https://doi.org/10.1146/annurev-pharmtox-051921-092701
/content/journals/10.1146/annurev-pharmtox-051921-092701
/content/journals/10.1146/annurev-pharmtox-051921-092701
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