Gene involved: CYP2C19

62-year-old male needs to be started on Plavix (clopidogrel) after stent placement for acute myocardial infarction (AMI)/acute coronary syndrome (ACS).

Genetic findings: CYP2C1 9PM (poor metaboliser)

Many studies have shown that CYP2C1 9 IMs and PMs have reduced active clopidogrel metabolite concentrations and higher on – treatment platelet activity compared to CYP2C19 NMs (normal metabolisers.) Moreover, substantial evidence exits linking CYP2C19 no functional levels with poorer clinical outcomes among patients with clopidogrel – treated acute coronary syndrome (ACS), particularly those undergoing percutaneous coronary intervention (PCI), likely as a result of decreased clopidogrel active metabolite formation. *1 2