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Clopidogrel (CYP2C19 Genotyping)

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Also known as: Clopidogrel Pharmacogenetic Testing; CYP2C19 Genotype
Formal name: CYP2C19 Sequence Genotype

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used. To access online sources, copy and paste the URL into your browser.

Sources Used in Current Review

Michael J. Knauer, Moderator, Eleftherios P. Diamandis, Moderator, Jean-Sebastien Hulot, Expert, Richard B. Kim, Expert and Derek Y.F. So, Expert. Clopidogrel and CYP2C19: Pharmacogenetic Testing Ready for Clinical Prime Time? Clinical Chemistry October 2015 vol. 61 no. 10 1235-1240. Available online at http://www.clinchem.org/content/61/10/1235.full. Accessed October 2015.

Gennaro Sardella, MD; Simone Calcagno, MD. The Importance of Genotype Variation Beyond Different Antiplatelet Therapy in Nonresponder Patients. J Am Coll Cardiol. 2014;64(3):333-334.

Bhopalwala A, et al. Routine Screening for CYP2C19 Polymorphisms for Patients being Treated with Clopidogrel is not Recommended. Hawaii J Med Public Health. 2015 Jan; 74(1): 16–20. Available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4300541/. Accessed October 2015.

Levine G, et al. Expert consensus document: World Heart Federation expert consensus statement on antiplatelet therapy in East Asian patients with ACS or undergoing PCI. Nature Reviews Cardiology 11, 597–606 (2014). Available online at http://www.nature.com/nrcardio/journal/v11/n10/full/nrcardio.2014.104.html. Accessed October 2015.

Sources Used in Previous Reviews

Holmes, D et al. (2010 June 28). ACCF/AHA Clopidogrel Clinical Alert: Approaches to the FDA "Boxed Warning" A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents and the American Heart Association. Circulation. 2010; 122: 537-557 [On-line information]. PDF available for download at http://circ.ahajournals.org/content/122/5/537.full.pdf. Accessed July 2011.

(Reviewed 2010 November 1). Clopidogrel. MedlinePlus Drug Information [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601040.html. Accessed July 2011.

Malone, Bill (2009 March 26). Predicting Response to Clopidogrel New Evidence Links Genes with Outcomes. Clinical Laboratory Strategies [On-line information]. Available online at http://www.aacc.org/publications/strategies/archives/2009/Pages/032609.aspx. Accessed July 2011.

McMillin, G et al. (Updated 2010 August). Pharmacogenetics – PGx. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/PGx.html. Accessed July 2011.

(© 1995-2011). Unit Code 60439: Cytochrome P450 2C19 Genotype by Sequence Analysis Mayo Clinic Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/60439. Accessed July 2011.

Hughes, S. (2010 October 21). Vanderbilt Now Also Routinely Gene Testing for Clopidogrel Metabolizer Status. Medscape Today from Heartwire [On-line information]. Available online at http://www.medscape.com/viewarticle/731001. Accessed July 2011.

Momary, K. et. al. (2010 April 13). Genetic Causes of Clopidogrel Nonresponsiveness: Which Ones Really Count? Medscape Today from Pharmacotherapy. 2010;30(3):265-274 [On-line information]. Available online at http://www.medscape.com/viewarticle/719480. Accessed July 2011.

Nainggolan, L. (2010 December 21). Newly Identified Variants Are Major Predictors of Response to Clopidogrel. Medscape Today from Heartwire [On-line information]. Available online at http://www.medscape.com/viewarticle/734643. Accessed July 2011.

Hughes, S. (2011 May 5). New Study Refutes Role of PON1 Gene in Clopidogrel Treatment. Medscape Today from Heartwire [On-line information]. Available online at http://www.medscape.com/viewarticle/742206. Accessed July 2011.

Snyder, B. (2010 September 23). Patient genotypes guide drug therapy in new VU program. Reporter, Vanderbilt University Medical Center's Weekly Newspaper [On-line information]. Available online at http://www.mc.vanderbilt.edu/reporter/index.html?ID=9466. Accessed July 2011.

Hughes, S. (2010 July 22). Therapeutic Window Identified for Clopidogrel? Medscape Today from Heartwire [On-line information]. Available online at http://www.medscape.com/viewarticle/725625. Accessed July 2011.

Voora, D. and Shah, S. (2009 December 7). Defining the Link Between CYP2C19*2 and Clopidogrel Response. Medscape Today Viewpoints in Genomic Medicine [On-line information]. Available online at http://www.medscape.com/viewarticle/713197. Accessed July 2011.

Pagana, K. D. & Pagana, T. J. (© 2011). Mosby's Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 368-369.

Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO. Pp 1713-1717.

Linnea Baudhuin, Phd, DABMG. Assistant Professor of Laboratory Medicine. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.