What are the effects of CYP2C19 polymorphisms on clopidogrel pharmacokinetics?
CYP2C19 polymorphisms can affect the pharmacokinetics of clopidogrel, with carriers of reduced-function CYP2C19*2 alleles having lower levels of the active metabolite of clopidogrel, diminished platelet inhibition, and increased rates of major adverse cardiovascular events and stent thrombosis. However, other studies have not confirmed associations between CYP2C19 polymorphisms and adverse outcomes in clopidogrel-treated patients. Further studies are needed to clarify the risk associated with these genetic polymorphisms and to develop effective therapeutic strategies for carriers of allelic variants of responsible enzyme systems.