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Clopidogrel (Plavix) is a medicine to prevent blood clots, which can cause heart attacks and strokes. It may be prescribed after a heart attack, after angioplasty, and for people who have heart disease or peripheral arterial disease.
Some people have changes, or mutations, to a certain gene (CYP2C19). These changes may keep the body from being able to use clopidogrel to prevent blood clots. If a person with these genetic changes takes clopidogrel, the medicine may not work. This may raise the person's chance of having a heart attack or a stroke.
A DNA test can look for these changes. The test is done by swabbing the inside of your cheek.
This test alone is not enough to tell whether the medicine will help you. You also may have a test that shows how your body's platelets are working to clot blood. Having a platelet test after you take clopidogrel can show if the medicine is working.
Experts are still studying whether this genetic test helps doctors know who can benefit from clopidogrel. If your doctor thinks that your body is not using clopidogrel properly, he or she may give you this test.
Other Works Consulted
Holmes DR, et al. (2010). 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, 122(5): 537–557.
Mega JL, et al. (2010). Reduced-function CYP2C19 genotype and risk of adverse clinical outcomes among patients treated with clopidogrel predominantly for PCI: A meta-analysis. JAMA, 304(16): 1821–1830.
Paré G, et al. (2010). Effects of CYP2C19 genotype on outcomes of clopidogrel treatment. New England Journal of Medicine, 363(18): 1704–1714.
Smith SC Jr, et al. (2006). ACC/AHA/SCAI 2005
guidelines update for percutaneous coronary intervention: Summary article. A
report of the American College of Cardiology/American Heart Association Task
Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update the 2001
Guidelines for Percutaneous Coronary Intervention). Circulation, 113(1): 156–175.
February 1, 2012
Kathleen Romito, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
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