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Clopidogrel Platelet Function Tests

Caveats and Controversies



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Caveats — Other Reasons for Poor Response to Clopidogrel

Slide 30

December 2011

There are several other factors which are known to affect clopidogrel metabolism. Smoking, caffeine and use of the herb St. John’s wort will affect clopidogrel metabolism. Medications that are metabolized by CYP enzymes other than the CYP2C19 enzyme can cause variability in clopidogrel metabolism. Some medications are known to increase the activity of the CYP2C19 enzyme, while other will decrease the activity of the enzyme. Both diabetes and high body mass index are independent risk factors for poor metabolism of clopidogrel regardless of CYP2C19 status. There is another enzyme which may affect clopidogrel variability more than the CYP2C19 enzyme and this is the paroxonase-1 (PON1) enzyme.

Other Reasons for Poor Response to Clopidogrel

 


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