Abstract
Background: Clopidogrel resistance can be defined as the failure of clopidogrel to inhibit its target of action. The prevalence of clopidogrel resistance in various studies ranges between 5%–44%. Clopidogrel resistance is a serious scary condition whereby clopidogrel drug is less or not effective for some patients than expected. Hence the present Systematic review was conducted to explore the new perspectives of Clopidogrel and to evaluate the effect of genetic cytochrome CYP2C19 (CYP2C19*2, CYP2C19*3) of the key drug metabolizing enzymes on the response to the anti-platelet effect of clopidogrel. To provide insights into the commentary summarizes the clinical evidence on the pharmacokinetic determinants of clopidogrel efficacy.
 Material and Method: Systematic review is a type of literature reviews that collects and critically analyzes multiple research studies using methods that are selected before one or more research questions are formulated and then finding and analyzing studies that relate to and answer those questions in a structured methodology.
 Results: Accumulated information from suggested the presence of high incidence of clopidogrel resistance. Associated with acute coronary syndrome (ACS), Acute myocardial infarction (AMI) and stroke. There was no significant difference in the incidence of resistance according to the type of studies.
 Conclusion: Accumulated information from previous studies and the present systematic review suggested the presence of high incidence of clopidogrel resistance. This resistance was associated with serious complications such as acute coronary syndrome (ACS), Acute myocardial infarction (AMI) and stroke.
Highlights
Coagulation is the process by which the blood changes from a liquid form to a form which seems like a gel, in other words, the blood clots
In a Retrospective cohort created by sen et al (2014) in Turkey, 51 patients taken clopidogrel were included in this study (21 males, 30 females), 3 patients (5.8%) showed resistance to clopidogrel [9]
In a Case control study done by Idrissi et al (2018) in Morocco, 75 patients taken clopidogrel were included in this study (42 males, 33 females), 5 patients (6.6%) showed resistance to clopidogrel [10]
Summary
Coagulation is the process by which the blood changes from a liquid form to a form which seems like a gel, in other words, the blood clots. The body activates the process of coagulation in collaboration of fibrin deposit and the action of the platelet, the blood clots to stop the bleeding [1]. Antiplatelets are agents that are introduced in the body which reduce the capability of platelets to stick together These agents are normally employed to help patients under high risk of myocardial infarction. Results: Accumulated information from suggested the presence of high incidence of clopidogrel resistance. Conclusion: Accumulated information from previous studies and the present systematic review suggested the presence of high incidence of clopidogrel resistance. This resistance was associated with serious complications such as acute coronary syndrome (ACS), Acute myocardial infarction (AMI) and stroke
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