Clopidogrel-induced mixed hepatocellular and cholestatic liver injury.

An 81-year-old woman developed symptomatic liver disease 3 weeks after beginning clopidogrel as adjunctive antiplatelet therapy for a coronary stent implantation. Symptomatic liver disease associated with short-term periprocedural administration of clopidogrel for coronary stenting has not been well described. The clinical significance of this event as well as a possible interaction between clopidogrel and other drugs metabolized by the cytochrome P450 2C9 pathways coadministered to this patient are discussed.