This article reviews the available published data on optimizing clopidogrel and aspirin therapy using translational and integrative medicine. Translational and evidence-based medical studies show that the

CYP2C19

gene mutation (

CYP2C19*2

and

CYP2C19*3

) could affect

>

50% of the Chinese population

and that this mutation is closely associated with clopidogrel resistance and an increased risk of major adverse cardiovascular events

particularly stent thrombosis in patients following percutaneous coronary intervention (PCI). Adjusted-dose warfarin and aspirin reduce stroke in patients with atrial fibrillation (AF)

and warfarin is substantially more efficacious than aspirin. However

a poor compliance is a big problem in warfarin use especially in China. The genetic variants of vitamin K expoxide reductase might account for the universally lower warfarin dosage used in Chinese population. The available evidence indicates that the integrating mainstream treatments (e.g.

clopidogrel

CYP2C19 genotyping) and non-mainstream medicines [e.g.

Chinese medicines

Naoxintong Capsule (脑心通胶囊

NXT)] to treat

CYP2C19

gene mutation patients following PCI can be effective. Aspirin combined NXT and the adjusted-dose warfarin was equally effective in elderly patients with non-valvular AF in prevention of ischemic stroke.