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Antiplatelet therapy

Personalized medicine for clopidogrel resistance?

Nature Reviews Cardiology volume 6, pages 334–336 (2009)Cite this article

The benefits of clopidogrel in the treatment and prevention of coronary artery disease vary among patients. Studies have identified predictive markers of poor response to clopidogrel that might allow risk stratification of patients. Are we ready to enter the age of personalized medicine?

Dual treatment with clopidogrel and aspirin is a cornerstone of cardiovascular antiplatelet therapy, including after percutaneous coronary angioplasty and stenting, in the prevention of thrombotic events.1 However, a growing body of evidence demonstrates that the efficiency of such therapy is widely variable among patients, and a substantial number of ischemic events still occur under treatment. Approximately 25% of patients treated with standard loading and maintenance clopidogrel doses display poor responsiveness, characterized by low inhibition of platelet aggregation when assessed biologically.2 Poor pharmacodynamic response to clopidogrel is associated with an increased risk of atherothrombotic and ischemic events under treatment.3 In this context, the challenge is to identify patients with high residual platelet reactivity (RPR) under clopidogrel therapy, with the hope to propose alternative antiplatelet strategies in such patients.

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  1. Cardiovascular Research Center, Mount Sinai School of Medicine, New York, NY, USA

    Jean-Sébastien Hulot & Valentin Fuster

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  1. Jean-Sébastien Hulot
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  2. Valentin Fuster
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Correspondence to Jean-Sébastien Hulot.

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Hulot, JS., Fuster, V. Personalized medicine for clopidogrel resistance?. Nat Rev Cardiol 6, 334–336 (2009). https://doi.org/10.1038/nrcardio.2009.28

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  • DOI: https://doi.org/10.1038/nrcardio.2009.28

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