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Int. J. Environ. Res. Public Health 2017, 14(3), 301; doi:10.3390/ijerph14030301

Pharmacokinetic and Pharmacodynamic Responses to Clopidogrel: Evidences and Perspectives

1
Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, China
2
Institute of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, Central South University, Changsha 410078, China
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 8 February 2017 / Revised: 2 March 2017 / Accepted: 7 March 2017 / Published: 14 March 2017
(This article belongs to the Section Public Health)
View Full-Text   |   Download PDF [565 KB, uploaded 14 March 2017]   |  

Abstract

Clopidogrel has significantly reduced the incidence of recurrent atherothrombotic events in patients with acute coronary syndrome (ACS) and in those undergoing percutaneous coronary intervention (PCI). However, recurrence events still remain, which may be partly due to inadequate platelet inhibition by standard clopidogrel therapy. Genetic polymorphisms involved in clopidogrel’s absorption, metabolism, and the P2Y12 receptor may interfere with its antiplatelet activity. Recent evidence indicated that epigenetic modification may also affect clopidogrel response. In addition, non-genetic factors such as demographics, disease complications, and drug-drug interactions can impair the antiplatelet effect of clopidogrel. The identification of factors contributing to the variation in clopidogrel response is needed to improve platelet inhibition and to reduce risk for cardiovascular events. This review encompasses the most recent updates on factors influencing pharmacokinetic and pharmacodynamic responses to clopidogrel. View Full-Text
Keywords: clopidogrel; pharmacogenomics; genetic polymorphisms; epigenetics; non-genetic factors clopidogrel; pharmacogenomics; genetic polymorphisms; epigenetics; non-genetic factors
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MDPI and ACS Style

Zhang, Y.-J.; Li, M.-P.; Tang, J.; Chen, X.-P. Pharmacokinetic and Pharmacodynamic Responses to Clopidogrel: Evidences and Perspectives. Int. J. Environ. Res. Public Health 2017, 14, 301.

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