Clopidogrel

Clopidogrel is an antiplatelet medication that irreversibly inhibits platelet P2Y₁₂ receptors after metabolic activation. It reduces platelet aggregation and helps prevent cardiovascular events caused by blood clots.

P2Y₁₂ receptor: A platelet receptor for ADP that promotes platelet activation and aggregation. Clopidogrel’s active metabolite irreversibly blocks this receptor.
Acute coronary syndrome: A group of conditions caused by sudden reduction of blood flow to the heart, including heart attack and unstable angina. Clopidogrel is commonly used with aspirin to reduce recurrent ischemic events.
Bleeding: The escape of blood from damaged or abnormal blood vessels, ranging from minor to life-threatening. Clopidogrel’s inhibition of platelet function increases bleeding risk.
Ticlopidine: An older thienopyridine antiplatelet drug that irreversibly inhibits platelet P2Y₁₂ receptors. It preceded clopidogrel but is used less often because of serious blood-related adverse effects.
Thienopyridine: A class of drugs characterized by a sulfur-containing heterocyclic ring, including several antiplatelet agents. Clopidogrel belongs to this drug class, whose members inhibit P2Y₁₂ irreversibly.
Percutaneous coronary intervention: A catheter-based procedure that opens narrowed coronary arteries, often using a stent. Clopidogrel helps prevent clot formation within a coronary stent.
Clopidogrel resistance: Reduced platelet response to clopidogrel despite treatment, with several possible biological and clinical causes. Inadequate activation or other factors can leave platelet activity insufficiently suppressed.
Cangrelor: An intravenous, rapidly reversible P2Y₁₂ inhibitor with a short duration of action. It provides immediate platelet inhibition without clopidogrel’s oral dosing or metabolic activation.
CYP2C19: A liver enzyme that metabolizes many drugs and activates clopidogrel. Genetic and drug-related variation in this enzyme can reduce clopidogrel activation.
Dual antiplatelet therapy: Treatment with two antiplatelet drugs, most commonly aspirin and a P2Y₁₂ inhibitor. This combination is a standard strategy after acute coronary events and many stent procedures.

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