Pharmacogenetic guidance for antiplatelet treatment

摘要

Jason Roberts and colleagues (May 5, p 17O5)1 determined CYP2C19*2 allele status on the basis of novel point-of-care genetic testing and assessed the usefulness of prasugrel therapy to overcome high on-treatment platelet reactivity in CYP2C19*2 carriers.Several other CYP2C19 alleles (CYP2C19*3-*8) are also associated with loss of function.2 About 30% of white people carry CYP2C19 loss-of-function alleles, the most common of which is the *2 allele. However, 60-70% of east Asians carry a CYP2Q9 loss-of-f unction allele, 50% of whom carry the *2 allele and the rest of whom carry the *3 allele. The effect of CYP2C19*3 on clopidogrel pharmacodynamics seems to be greater than that of the CYP2C19*2 allele.