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Integrative Medicine on Optimizing Clopidogrel and Aspirin Therapy

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Abstract

This article reviews the available published data on optimizing clopidogrel and aspirin therapy using translational and integrative medicine. Translational and evidence-based medical studies show that the CYP2C19 gene mutation (CYP2C19*2 and CYP2C19*3) could affect > 50% of the Chinese population, and that this mutation is closely associated with clopidogrel resistance and an increased risk of major adverse cardiovascular events, particularly stent thrombosis in patients following percutaneous coronary intervention (PCI). Adjusted-dose warfarin and aspirin reduce stroke in patients with atrial fibrillation (AF), and warfarin is substantially more efficacious than aspirin. However, a poor compliance is a big problem in warfarin use especially in China. The genetic variants of vitamin K expoxide reductase might account for the universally lower warfarin dosage used in Chinese population. The available evidence indicates that the integrating mainstream treatments (e.g., clopidogrel, CYP2C19 genotyping) and non-mainstream medicines [e.g., Chinese medicines, Naoxintong Capsule (脑心通胶囊, NXT)] to treat CYP2C19 gene mutation patients following PCI can be effective. Aspirin combined NXT and the adjusted-dose warfarin was equally effective in elderly patients with non-valvular AF in prevention of ischemic stroke.

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Authors and Affiliations

  1. Department of Internal Medicine, Fujian Provincial Cardiovascular Disease Institute, the Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China

    Hui Chen

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  1. Hui Chen
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Correspondence to Hui Chen.

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Supported by the National Natural Science Fundation of China (No. 81373838), Ministry of Health of the People’s Republic of China of Fujian Province Health Education Union Scientific grants (No. WKJ 2008-2-59), and Provincial Natural Science Foundation of Fujian (No. 2011J0133)

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Chen, H. Integrative Medicine on Optimizing Clopidogrel and Aspirin Therapy. Chin. J. Integr. Med. 25, 395–400 (2019). https://doi.org/10.1007/s11655-017-2551-4

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