Overlooked hepatotoxicity with Clopidogrel

  • Jahanzeb Malik Registrar Cardiology, Rawalpindi Institute of Cardiology, Rawal Road, Rawalpindi, Pakistan
Keywords: drug-induced liver injury, clopidogril induced hepatotoxicity, p2y12 inhibitor side effects

Abstract

Clopidogrel is an adenosine diphosphate receptor blocker. It is widely used as a part of dual antiplatelet therapy (DAPT) in patients with ischemic heart disease (IHD), regardless of the acute coronary syndrome (ACS). Although a rarely reported entity, clopidogrel-induced liver injury is commonly seen in clinical practice. It is widely overlooked by clinicians and is thus a potential hazard to patients with IHD.

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References

Gong IY, Crown N, Suen CM, Schwarz UI, Dresser GK, Knauer MJ, et al. Clarifying the importance of CYP2C19 and PON1 in the mechanism of clopidogrel bioactivation and in vivo antiplatelet response. Eur Heart J. 2012; 33(22):2856-2464.

DOI: https://doi.org/10.1093/eurheartj/ehs042

Ferguson JJ. Clopidogrel plus aspirin in patients with acute myocardial infarction treated with fibrinolytic therapy--CLARITY-TIMI 28. Future Cardiol. 2005; 1(5):605-610.

DOI: https://doi.org/10.2217/14796678.1.5.605

Wiviott S.D, Antman E.M, Gibson C.M, Montalescot G, Riesmeyer J, Weerakkody G, et al. Evaluation of prasugrel compared with clopidogrel in patients with acute coronary syndromes: design and rationale for the TRial to assess Improvement in Therapeutic Outcomes by optimizing platelet InhibitioN with prasugrel Thrombolysis In Myocardial Infarction 38 (TRITON-TIMI 38). Am Heart J. 2006; 152(4):627-635.

DOI: https://doi.org/10.1016/j.ahj.2006.04.012

CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet. 1996 Nov 16; 348(9038):1329-39.

DOI: https://doi.org/10.1016/S0140-6736(96)09457-3.

Gerschutz GP, Bhatt DL. The CURE trial: using clopidogrel in acute coronary syndromes without ST-segment elevation. Cleve Clin J Med. 2002; 69(5):377-8.

DOI: https://doi.org/10.3949/ccjm.69.5.377

Garton M. COMMIT/CCS-2 studies. Lancet. 2006; 368(9536):642-643.

DOI: https://doi.org/10.1016/S0140-6736(06)69235-0

López-Vicente J, Garfia C, López-Medrano F, Yela C. Hepatic toxicity and clopidogrel-induced systemic inflammatory response syndrome. Rev Esp Cardiol. 2007; 60(3):323-4.

LiverTox: Clinical and Research Information on Drug-Induced Liver Injury (Internet). Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012. Clopidogrel.

Wiper A, Schmitt M, Roberts DH. Clopidogrel-induced hepatotoxicity. J Postgrad Med. 2008; 54(2):152.

DOI: https://doi.org/10.4103/0022-3859.40787

Moriyama B, Obeng AO, Barbarino J, Penzak SR, Henning SA, Scott SA. et al. Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for CYP2C19 and Voriconazole Therapy. Clin Pharmacol Ther. 2017; 102(1):45-51.

DOI: https://doi.org/10.1002/CPT.583

Keshmiri H, Behal A, Shroff S, Berkelhammer C. Clopidogrel-Induced Severe Hepatitis: A Case Report and Literature Review. Case Reports Hepatol. 2016.

DOI: https://doi.org/1155/2016/8068276

Published
2020-12-23
How to Cite
1.
Malik J. Overlooked hepatotoxicity with Clopidogrel. JSTMU [Internet]. 23Dec.2020 [cited 19Jun.2021];3(2):132-3. Available from: https://j.stmu.edu.pk/ojs/index.php/jstmu/article/view/100