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Clopidogrel Platelet Function Tests

Caveats and Controversies



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CYP2C19 Polymorphism May Require Another Factor

Slide 31

December 2011

Not all patients with CYP2C19 polymorphisms are resistant to clopidogrel. Of 6 patients with one polymorphism at our institution, only 2 were resistant by VerifyNow testing. In one study, even some patients with 2 polymorphisms were not resistant by VASP testing. Studies have shown that patients with diabetes, high BMI or age over 70 years with a CYP2C19 polymorphism have poorer metabolism of clopidogrel than expected from the CYP2C19 polymorphism alone. We have already mentioned the platelet ADP receptor polymorphism, the duodenal absorption polymorphism and the PON1 enzyme activity and these in combination with a CYP2C19 polymorphism, may decrease clopidogrel metabolism more profoundly.

Polymorphism May Require Another Factor

 


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