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Genotypic and Phenotypic Assessment of Platelet Function and Response to P2Y12 Antagonists

Current Cardiology Reports volume 13, Article number: 439 (2011) Cite this article

Abstract

The P2Y12-ADP receptor antagonists are the cornerstone of oral antiplatelet therapy in the secondary prevention of coronary artery disease, especially after acute coronary syndrome or percutaneous coronary intervention. Currently, the therapeutic agents available to block the receptor include clopidogrel and prasugrel; ticagrelor is not available everywhere. Clopidogrel was the gold standard, but recently it has been challenged by prasugrel and ticagrelor. One pitfall of clopidogrel is that in some patients it cannot induce optimal platelet reactivity inhibition in connection with several factors, including some genetic polymorphisms of enzymes participating in its bioabsorption or metabolism. This variability of response can be evaluated by platelet reactivity monitoring. This comprehensive review provides the available data regarding the genotypic and phenotypic interaction with the response to P2Y12-ADP receptor antagonists and discusses the concept of personalized antiplatelet therapy based on a genotypic or phenotypic profile.

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Conflicts of Interest

L. Bonello: consulting fees from AstraZeneca and Daichi Sankyo, and payment for educational presentations or speaking from AstraZeneca, Sanofi, and Lilly; A. de Labriolle: none; J.P. Doazan: none; G. Lemesle: none.

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Affiliations

  1. Service de cardiologie, Clinique du pont de chaume, Montauban, France

    Axel de Labriolle

  2. Service de cardiologie, Centre hospitalier général de Montauban, Montauban, France

    Jean Philippe Doazan

  3. Service de cardiologie, Centre hospitalier universitaire de Lille, Lille, France

    Gilles Lemesle

  4. Service de cardiologie, Hopital nord de Marseille, Chemin des bourrely, 13015, Marseille, France

    Laurent Bonello

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  1. Axel de Labriolle
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  2. Jean Philippe Doazan
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  3. Gilles Lemesle
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  4. Laurent Bonello
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Correspondence to Laurent Bonello.

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de Labriolle, A., Doazan, J.P., Lemesle, G. et al. Genotypic and Phenotypic Assessment of Platelet Function and Response to P2Y12 Antagonists. Curr Cardiol Rep 13, 439 (2011). https://doi.org/10.1007/s11886-011-0208-z

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Keywords

  • P2Y12-ADP receptor
  • Adenosine diphosphate
  • Stent thrombosis
  • Acute coronary syndrome
  • Platelet reactivity
  • Individualized therapy
  • Pharmacogenomics
  • Antiplatelet therapy