Carriers of the CYP2C19*2 and *4 alleles showed reduced platelet inhibition after a clopidogrel 600-mg loading dose but responded to higher loading and maintenance dose regimens. Genotyping for the relevant gene polymorphisms may help to individualize and optimize clopidogrel treatment. (Australia New Zealand Clinical Trials Registry; ACTRN12606000129583).
A 54 year old woman with isolated stenosis of the left coronary ostium died following cardiac catheterisation and emergency coronary artery bypass surgery. Histological examination showed the ostial narrowing to be a local and discrete plaque of atherosclerosis. Like most reported cases this patient was a young woman whose disease pursued an aggressive course.
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