The Personalization of Clopidogrel Antiplatelet Therapy: The Role of Integrative Pharmacogenetics and Pharmacometabolomics

Amin, Arwa M. and Lim, Sheau Chin and Mohamed Noor, Dzul Azri and SK Abdul Kader, Muhamad Ali and Yuen, Kah Hay and Ibrahim, Baharudin (2017) The Personalization of Clopidogrel Antiplatelet Therapy: The Role of Integrative Pharmacogenetics and Pharmacometabolomics. Cardiology Research and Practice, 2017 (806279). pp. 1-17. ISSN 2090-8016

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    Abstract

    Dual antiplatelet therapy of aspirin and clopidogrel is pivotal for patients undergoing percutaneous coronary intervention. However, the variable platelets reactivity response to clopidogrel may lead to outcome failure and recurrence of cardiovascular events. Although many genetic and nongenetic factors are known, great portion of clopidogrel variable platelets reactivity remain unexplained which challenges the personalization of clopidogrel therapy. Current methods for clopidogrel personalization include CYP2C19 genotyping, pharmacokinetics, and platelets function testing. However, these methods lack precise prediction of clopidogrel outcome, often leading to insufficient prediction. Pharmacometabolomics which is an approach to identify novel biomarkers of drug response or toxicity in biofluids has been investigated to predict drug response. The advantage of pharmacometabolomics is that it does not only predict the response but also provide extensive information on the metabolic pathways implicated with the response. Integrating pharmacogenetics with pharmacometabolomics can give insight on unknown genetic and nongenetic factors associated with the response.This review aimed to review the literature on factors associated with the variable platelets reactivity response to clopidogrel, as well as appraising current methods for the personalization of clopidogrel therapy. We also aimed to review the literature on using pharmacometabolomics approach to predict drug response, as well as discussing the plausibility of using it to predict clopidogrel outcome.

    Item Type: Article
    Additional Information: Article ID 8062796
    Subjects: R Medicine > RS Pharmacy and materia medica > RS1-441 Pharmacy and materia medica
    Divisions: Pusat Pengajian Sains Farmasi (School of Pharmacy) > Article
    Depositing User: Mr Noorazilan Noordin
    Date Deposited: 30 Oct 2017 11:58
    Last Modified: 30 Oct 2017 11:58
    URI: http://eprints.usm.my/id/eprint/37261

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