Cytochrome P450 2C19 loss-of-function polymorphism is a major determinant of clopidogrel responsiveness in healthy subjects.

By J. Hulot, A. Bura, E. Villard, Michel Azizi, V. Remones, C. Goyenvalle, M. Aiach, P. Lechat, P. Gaussem. Blood, 2006

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Cytochrome P450 enzymes in drug metabolism: regulation of gene expression, enzyme activities, and impact of genetic variation. (2013, background): “The CYP2C19 enzyme was later shown to be the major enzyme for the inactivating metabolism of proton pump inhibitors (PPI) including omeprazole and pantoprazole, and for the metabolic activation of the anticoagulant clopidogrel to the active 2-oxo metabolite (Hulot et al., 2006; Kazui et al., 2010; D”
Influence of omeprazole on the antiplatelet action of clopidogrel associated with aspirin: the randomized, double-blind OCLA (Omeprazole CLopidogrel Aspirin) study. (2008, background): “The isoenzyme CYP2C19 seems to be one of the determinants of the pharmacodynamic response to clopidogrel ( 6 ), and is also involved in the metabolism of proton pump inhibitors (PPIs), such as omeprazole (7).”
Identification of the Human Cytochrome P450 Enzymes Involved in the Two Oxidative Steps in the Bioactivation of Clopidogrel to Its Pharmacologically Active Metabolite (2010, background): “…on the pharmacodynamic response of clopidogrel, and studies on the effect of genetic polymorphism of CYP2C19 on the clinical outcomes in patients treated with clopidogrel (Hulot et al., 2006; Suh et al., 2006; Brandt et al., 2007; Farid et al., 2007, 2008; Mega et al., 2009; Simon et al., 2009).”