{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:38:49Z","timestamp":1786977529010,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T00:00:00Z","timestamp":1765670400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T00:00:00Z","timestamp":1765670400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2026,4]]},"abstract":"\n The impact of\n CYP2C19<\/jats:italic>\n genotype in relation to clinical risk is unclear during clopidogrel treatment following drug\u2010eluting stent (DES) implantation. This study aimed to evaluate the prognostic significance of\n CYP2C19<\/jats:italic>\n genotypes based on clinical risk stratification in DES\u2010treated patients. From the nationwide multicenter PTRG\u2010DES (Platelet function and genoType\u2010Related long\u2010term progGosis in DES\u2010treated patients) consortium, patients were classified according to the presence of\n CYP2C19<\/jats:italic>\n loss\u2010of\u2010function (LoF) allele: rapid or normal metabolizers (RMs\/NMs) vs. intermediate or poor metabolizers (IMs\/PMs), and clinical risk was stratified using the CHADS\u2010P\n 2<\/jats:sub>\n A\n 2<\/jats:sub>\n RC and TRS 2\u00b0P scores. The primary endpoint (1\u00b0EP) was a composite of cardiac death, myocardial infarction, and stent thrombosis during a 3\u2010year follow\u2010up. Among clopidogrel\u2010treated patients with\n CYP2C19<\/jats:italic>\n genotyping (\n n<\/jats:italic>\n \u2009=\u20098,163), IMs\/PMs (62.1%) demonstrated an increased risk of 1\u00b0EP compared with RMs\/NMs (hazard ratio [HR]: 1.48; 95% confidence interval [CI]: 1.05\u20132.07; Log\u2010rank\n P<\/jats:italic>\n \u2009<\u20090.001), Most notable in those with high CHADS\u2010P2A2RC (\u2265\u20094) and TRS 2\u00b0P (\u2265\u20093) scores (HR\n adj<\/jats:sub>\n : 1.68; 95% CI: 1.01\u20132.80;\n P<\/jats:italic>\n \u2009=\u20090.047 and HR\n adj<\/jats:sub>\n : 1.63; 95% CI: 1.05\u20132.54;\n P<\/jats:italic>\n \u2009=\u20090.029, respectively). In patients with low scores, there was no difference in 1\u00b0EP between IMs\/PMs vs. RMs\/NMs; however, an interaction was observed between acute and chronic coronary syndromes for both low CHADS\u2010P\n 2<\/jats:sub>\n A\n 2<\/jats:sub>\n RC (HR\n adj<\/jats:sub>\n : 2.12; 95% CI: 1.11\u20134.03 and HR\n adj<\/jats:sub>\n : 0.68; 95% CI: 0.34\u20131.36;\n P<\/jats:italic>\n interaction<\/jats:sub>\n \u2009=\u20090.017) and TRS 2\u00b0P scores (HR\n adj<\/jats:sub>\n : 2.34; 95% CI: 1.07\u20135.12 and HR\n adj<\/jats:sub>\n : 0.52; 95% CI: 0.22\u20131.17;\n P<\/jats:italic>\n interaction<\/jats:sub>\n \u2009=\u20090.008). Among clopidogrel\u2010treated patients, the carriage of the\n CYP2C19<\/jats:italic>\n LoF allele was associated with higher ischemic risk, particularly in those with high clinical risk or an acute coronary syndrome presentation.\n <\/jats:p>","DOI":"10.1002\/cpt.70154","type":"journal-article","created":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T11:12:21Z","timestamp":1765710741000},"page":"928-941","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prognostic Implication of\n CYP2C19<\/i>\n Genotype According to Clinical Risk Stratification After Drug\u2010Eluting Stent Implantation"],"prefix":"10.1002","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2025-7781","authenticated-orcid":false,"given":"Hyun Woong","family":"Park","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal medicine, Chungnam National University Hospital Chungnam National University School of Medicine Daejeon South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6561-7760","authenticated-orcid":false,"given":"Jae\u2010Hwan","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal medicine, Chungnam National University Hospital Chungnam National University School of Medicine Daejeon South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0763-4754","authenticated-orcid":false,"given":"Jin\u2010Ok","family":"Jeong","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal medicine, Chungnam National University Hospital Chungnam National University School of Medicine Daejeon South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9286-1451","authenticated-orcid":false,"given":"Diana A.","family":"Gorog","sequence":"additional","affiliation":[{"name":"School of Life and Medical Sciences, Postgraduate Medical School University of Hertfordshire London UK"},{"name":"Imperial College, National Heart & Lung Institute London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8542-8596","authenticated-orcid":false,"given":"Udaya S.","family":"Tantry","sequence":"additional","affiliation":[{"name":"Sinai Center for Thrombosis Research and Drug Development Sinai Hospital of Baltimore Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2493-066X","authenticated-orcid":false,"given":"Byeong\u2010Keuk","family":"Kim","sequence":"additional","affiliation":[{"name":"Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1846-8464","authenticated-orcid":false,"given":"Hyung Joon","family":"Joo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital Korea University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyuk","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Catholic University of Korea Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6632-7239","authenticated-orcid":false,"given":"Jin\u2010Yong","family":"Hwang","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Gyeongsang National University Hospital Gyeongsang National University School of Medicine Jinju South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Bin","family":"Song","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1528-2739","authenticated-orcid":false,"given":"Sung Gyun","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Cardiology Yonsei University Wonju Severance Christian Hospital Wonju South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung\u2010Won","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0959-1738","authenticated-orcid":false,"given":"Woong Gil","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Chungbuk National University College of Medicine Cheongju South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Rae","family":"Cho","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Internal Medicine, Kangnam Sacred Heart Hospital Hallym University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9078-2231","authenticated-orcid":false,"given":"Jeehoon","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center Seoul National University Hospital Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Yeub","family":"Lee","sequence":"additional","affiliation":[{"name":"CAU Thrombosis and Biomarker Center Chung\u2010Ang University Gwangmyeong Hospital Gwangmyeong South Korea"},{"name":"Department of Internal Medicine Chung\u2010Ang University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0847-5329","authenticated-orcid":false,"given":"Hyo\u2010Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center Seoul National University Hospital Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3468-6453","authenticated-orcid":false,"given":"Moo Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dong\u2010A University Hospital Busan South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do\u2010Sun","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital Korea University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9169-6968","authenticated-orcid":false,"given":"Eun\u2010Seok","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ulsan University Hospital University of Ulsan College of Medicine Ulsan South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Gurbel","sequence":"additional","affiliation":[{"name":"Sinai Center for Thrombosis Research and Drug Development Sinai Hospital of Baltimore Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0403-3726","authenticated-orcid":false,"given":"Young\u2010Hoon","family":"Jeong","sequence":"additional","affiliation":[{"name":"CAU Thrombosis and Biomarker Center Chung\u2010Ang University Gwangmyeong Hospital Gwangmyeong South Korea"},{"name":"Department of Internal Medicine Chung\u2010Ang University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the PTRG\u2010DES Consortium 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