Poor responders to clopidogrel have low levels of circulating active metabolite. However, in vitro experiments have shown that blood platelets from poor responders are fully inhibited by the active metabolite of this prodrug. Impaired platelet inhibition reflects inadequate plasma levels of active metabolites, and not differences in platelet P2Y12 receptor function.
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The author declared that he his a consultant for Astra-Zeneca, Bayer, Eli Lilly, Sanofi-Aventis and Servier, has received speakers bureau from Bayer, Eli Lilly and Schering-Plough, and grant/research support from Bayer and Servier.
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Patrono, C. The P2Y12 receptor: no active metabolite, no party. Nat Rev Cardiol 6, 271–272 (2009). https://doi.org/10.1038/nrcardio.2009.29
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DOI: https://doi.org/10.1038/nrcardio.2009.29
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