The Personalization of Clopidogrel Antiplatelet Therapy: The Role of Integrative Pharmacogenetics and Pharmacometabolomics
Dual antiplatelet therapy of aspirin and clopidogrel is pivotal for patients undergoing percutaneous coronary intervention. However, the variable platelets reactivity response to clopidogrel may lead to outcome failure and recurrence of cardiovascular events. Although many genetic and nongenetic f...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Hindawi Publishing Corporation
2017
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| Subjects: | |
| Online Access: | http://eprints.usm.my/37261/ http://eprints.usm.my/37261/1/%28The_Personalization_of_Clopidogrel_Antiplatelet%29_8062796.pdf |
| Summary: | Dual antiplatelet therapy of aspirin and clopidogrel is pivotal for patients undergoing percutaneous coronary intervention.
However, the variable platelets reactivity response to clopidogrel may lead to outcome failure and recurrence of cardiovascular
events. Although many genetic and nongenetic factors are known, great portion of clopidogrel variable platelets reactivity
remain unexplained which challenges the personalization of clopidogrel therapy. Current methods for clopidogrel personalization
include CYP2C19 genotyping, pharmacokinetics, and platelets function testing. However, these methods lack precise prediction
of clopidogrel outcome, often leading to insufficient prediction. Pharmacometabolomics which is an approach to identify
novel biomarkers of drug response or toxicity in biofluids has been investigated to predict drug response. The advantage of
pharmacometabolomics is that it does not only predict the response but also provide extensive information on the metabolic
pathways implicated with the response. Integrating pharmacogenetics with pharmacometabolomics can give insight on unknown
genetic and nongenetic factors associated with the response.This review aimed to review the literature on factors associated with
the variable platelets reactivity response to clopidogrel, as well as appraising current methods for the personalization of clopidogrel
therapy. We also aimed to review the literature on using pharmacometabolomics approach to predict drug response, as well as
discussing the plausibility of using it to predict clopidogrel outcome. |
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