{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T01:00:18Z","timestamp":1782435618750,"version":"3.54.5"},"reference-count":46,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,10,2]],"date-time":"2020-10-02T00:00:00Z","timestamp":1601596800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>Genotyping for <jats:italic>CYP2C19<\/jats:italic> no function alleles to guide antiplatelet therapy after percutaneous coronary intervention (PCI) improves clinical outcomes. Although results for the increased function <jats:italic>CYP2C19*17<\/jats:italic> allele are also reported, its clinical relevance in this setting remains unclear. A collaboration across nine sites examined antiplatelet therapy prescribing and clinical outcomes in 3,342 patients after implementation of <jats:italic>CYP2C19<\/jats:italic>\u2010guided antiplatelet therapy. Risk of major atherothrombotic and bleeding events over 12\u00a0months after PCI were compared across cytochrome P450 2C19 isozyme (CYP2C19) metabolizer phenotype and antiplatelet therapy groups by proportional hazards regression. Clopidogrel was prescribed to a similar proportion of CYP2C19 normal (84.5%), rapid (82.9%), and ultrarapid metabolizers (80.6%) (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.360). Clopidogrel\u2010treated normal metabolizers (20.4 events\/100 patient\u2010years; adjusted hazard ratio (HR) 1.00, 95% confidence interval (CI), 0.75\u20131.33, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.993) and clopidogrel\u2010treated rapid or ultrarapid metabolizers (19.1 events\/100 patient\u2010years; adjusted HR 0.95, 95% CI, 0.69\u20131.30, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.734) exhibited no difference in major atherothrombotic events compared with patients treated with prasugrel or ticagrelor (17.6 events\/100 patient\u2010years). In contrast, clopidogrel\u2010treated intermediate and poor metabolizers exhibited significantly higher atherothrombotic event risk compared with prasugrel\/ticagrelor\u2010treated patients (adjusted HR 1.56, 95% CI, 1.12\u20132.16, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.008). When comparing clopidogrel\u2010treated rapid or ultrarapid metabolizers to normal metabolizers, no difference in atherothrombotic (adjusted HR 0.97, 95% CI, 0.73\u20131.29, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.808) or bleeding events (adjusted HR 1.34, 95% CI, 0.83\u20132.17, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.224) were observed. In a real\u2010world setting of genotype\u2010guided antiplatelet therapy, the <jats:italic>CYP2C19*17<\/jats:italic> allele did not significantly impact post\u2010PCI prescribing decisions or clinical outcomes. These results suggest the <jats:italic>CYP2C19 *1\/*17<\/jats:italic> and <jats:italic>*17\/*17<\/jats:italic> genotypes have limited clinical utility to guide antiplatelet therapy after PCI.<\/jats:p>","DOI":"10.1002\/cpt.2039","type":"journal-article","created":{"date-parts":[[2020,9,14]],"date-time":"2020-09-14T07:45:13Z","timestamp":1600069513000},"page":"705-715","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Impact of the <i>CYP2C19*17<\/i> Allele on Outcomes in Patients Receiving Genotype\u2010Guided Antiplatelet Therapy After Percutaneous Coronary Intervention"],"prefix":"10.1111","volume":"109","author":[{"given":"Craig R.","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Pharmacotherapy and Experimental Therapeutics UNC Eshelman School of Pharmacy University of North Carolina at Chapel Hill Chapel Hill North Carolina 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