Influence of genetic polymorphisms on platelet function, response to antiplatelet drugs and clinical outcomes in patients with coronary artery disease

Udaya S. Tantry, Young Hoon Jeong, Eliano P. Navarese, Jacek Kubica, Paul A. Gurbel

Research output: Contribution to journalArticle

Abstract

Platelet activation and aggregation play important roles in ischemic event occurrences in patients with coronary artery disease. In the absence of a disease state and drug administration, platelet reactivity has been shown to be stable over time, indicating a high level of heritability. Interindividual variability in platelet response to agonists and in response to aspirin and clopidogrel administration along with the influence of different single nucleotide polymorphisms on platelet reactivity based on candidate gene and genome-wide association studies have been demonstrated in healthy subjects. Reduced pharmacodynamic effect and reduced clinical efficacy of clopidogrel have been well documented in high-risk coronary artery disease patients carrying a loss-of-function allele of the CYP2C19 gene. These factors are recognized by the recent American and European treatment guidelines. However, prasugrel and ticagrelor are associated with superior and predictable pharmacodynamic responses and better clinical outcomes compared with clopidogrel.

Original languageEnglish (US)
Pages (from-to)447-462
Number of pages16
JournalExpert Review of Cardiovascular Therapy
Volume11
Issue number4
DOIs
StatePublished - Apr 2013

Fingerprint

clopidogrel
Platelet Aggregation Inhibitors
Genetic Polymorphisms
Coronary Artery Disease
Blood Platelets
Genome-Wide Association Study
Platelet Activation
Platelet Aggregation
Aspirin
Genes
Single Nucleotide Polymorphism
Healthy Volunteers
Alleles
Guidelines
Pharmaceutical Preparations

Keywords

  • acute coronary syndrome
  • clopidogrel
  • coronary artery disease
  • genetic polymorphisms
  • genotyping
  • P2Y12 receptor blockers
  • platelet aggregation
  • prasugrel
  • ticagrelor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine

Cite this

Influence of genetic polymorphisms on platelet function, response to antiplatelet drugs and clinical outcomes in patients with coronary artery disease. / Tantry, Udaya S.; Jeong, Young Hoon; Navarese, Eliano P.; Kubica, Jacek; Gurbel, Paul A.

In: Expert Review of Cardiovascular Therapy, Vol. 11, No. 4, 04.2013, p. 447-462.

Research output: Contribution to journalArticle

Tantry, Udaya S. ; Jeong, Young Hoon ; Navarese, Eliano P. ; Kubica, Jacek ; Gurbel, Paul A. / Influence of genetic polymorphisms on platelet function, response to antiplatelet drugs and clinical outcomes in patients with coronary artery disease. In: Expert Review of Cardiovascular Therapy. 2013 ; Vol. 11, No. 4. pp. 447-462.
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