CardioExchange Archive

In response to the addition in March of a boxed warning on the Plavix (clopidogrel) label, the ACC and the AHA have published a clinical alert intended to provide guidance to clinicians. David Holmes, Jr, the chair of the writing group, said in a press release that “the majority of patients do very well with standard guideline-based clopidogrel, but for the small number of patients who have problems, these are big problems.”
The ACC and the AHA do not offer specific recommendations relating to genetic testing. They note that “many questions remain about how and when to use genetic tests, which tests to use, as well as whether they will be reimbursed.” Holmes also noted that newer agents such as prasugrel “appear to have fewer genetic issues, but have the potential for more bleeding and higher costs.”
“Genetic testing, use of alternate drugs or using alternate dosing strategies with clopidogrel might be reasonable in some patients who have taken the drug as directed, but have experienced an adverse event either because the drug did not work or worked too well and caused bleeding,” said Dr. Holmes.