The role of clopidogrel in disruption of platelet aggregation is well known. The variability in clopidogrel response is a well-documented phenomenon and has been widely addressed through pharmacogenomics. CYP2C19 has been considered as genetic predictor of clopidogrel response. Owing to the inter-individual variations, CPIC (Clinical Pharmacogenetics Implementation Consortium) had issued guidelines in compliance with FDA. However, based on the genetic proofs clinical utility is more or less unsuccessful. The use of miRNAs to predict drug response and the introduction of miRNA-pharmacogenomics holds promise to bridge this gap and may improves the clinical utility by synergistically addressing the issue through genetic variations and miRNAs.
Anu Radha Sharma and Padmalatha S Rai*