Genotype Testing for Clopidogrel Responsiveness May Not Predict Events

A meta-analysis finds no association between CYP2C19 genotype and cardiovascular outcomes in clopidogrel recipients, but concerns about stent thrombosis linger.

Variation in individual response to clopidogrel's antiplatelet activity is, in part, governed by genetic variation in the CYP2C19 activating enzyme. To examine the effect of genetic variants on clopidogrel responsiveness and cardiovascular events, investigators conducted a meta-analysis of 32 studies involving 42,016 patients (mean age, 63 years; 29% women). Included were 21 studies in patients with acute coronary syndromes, 8 in patients with stable coronary disease (recruited mostly at the time of stent implantation), and 3 in patients with unspecified disease status.

In a “treatment-only” analysis of 22 prospective, observational studies and the treatment arms of 4 randomized trials, any copy of a reduced-function CYP2C19 allele was assoc…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI