1. Copyleft Clinical Trial Results. You Must Redistribute Slides The American College of Cardiology Foundation / American Heart Association Clopidogrel Recommendations for Practice

2. Copyleft Clinical Trial Results. You Must Redistribute Slides Recommendations for Practice Adherence to existing ACCF/AHA guidelines for the use of antiplatelet therapy should remain the foundation for therapy.Adherence to existing ACCF/AHA guidelines for the use of antiplatelet therapy should remain the foundation for therapy. Clinicians must be aware that genetic variability in CYP enzymes alter clopidogrel metabolism, which in turn can affect its inhibition of platelet function.Clinicians must be aware that genetic variability in CYP enzymes alter clopidogrel metabolism, which in turn can affect its inhibition of platelet function. The specific impact of the individual genetic polymorphisms on clinical outcome remains to be determined.The specific impact of the individual genetic polymorphisms on clinical outcome remains to be determined. Information regarding the predictive value of pharmacogenomic testing is very limited at this time; resolution of this issue is the focus of multiple ongoing studies.Information regarding the predictive value of pharmacogenomic testing is very limited at this time; resolution of this issue is the focus of multiple ongoing studies. David Holmes, et al, ACCF/AHA Clinical Alert, 2010

3. Copyleft Clinical Trial Results. You Must Redistribute Slides Recommendations for Practice The evidence base is insufficient to recommend either routine genetic or platelet function testing at the present time.The evidence base is insufficient to recommend either routine genetic or platelet function testing at the present time. There are several possible therapeutic options for patients who experience an adverse event while taking clopidogrel in the absence of any concern about medication compliance.There are several possible therapeutic options for patients who experience an adverse event while taking clopidogrel in the absence of any concern about medication compliance. Alternative dosing strategies or newer antiplatelet drugs could improve platelet inhibition and might be considered.Alternative dosing strategies or newer antiplatelet drugs could improve platelet inhibition and might be considered. David Holmes, et al, ACCF/AHA Clinical Alert, 2010

4. Copyleft Clinical Trial Results. You Must Redistribute SlidesConclusions Because of a lack of evidence-based data, specific recommendations and strategies for routine genetic testing and identification of optimal care strategies cannot be offered at this time. “The evidence base is insufficient to recommend either routine genetic or platelet function testing at the present time. There is no information that routine testing improves outcome in large subgroups of patients. In addition, the clinical course of the majority of patients treated with clopidogrel without either genetic testing or functional testing is excellent. …Careful clinical judgment is required to assess the importance of the variability in response to clopidogrel for an individual patient and its associated risk to the patient.” David Holmes, et al, ACCF/AHA Clinical Alert, 2010