For the last year, there’s been a huge palaver regarding clopidogrel and people with certain genotype – particularly CYP polymorphisms that would lead to the drug not working, and therefore worse cardiovascular outcomes. Some people said that even though that’s a theoretical possibility, but not borne out in reality. Then the FDA guidelines said you could consider genotype testing. Finally, here’s a meta-analysis to settle the argument.
Looking at 32 studies, with over 42,000 patients, there was overall a higher risk of CVD events in those alleles associated with lower enzyme activity – but then once all the small studies were taken out, the risk was attenuated. So, there is an association with the genotype and clopidogrel responsiveness, but not necessarily enough to cardiovascular events.
It’s over at JAMA, here.