{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:57:59Z","timestamp":1790927879281,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"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":[[2026,10]]},"abstract":"<jats:p>\n                    Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel is commonly used for secondary prevention following acute ischemic stroke (AIS) and neurointerventional procedures. However, the efficacy of clopidogrel is reduced in carriers of\n                    <jats:italic>CYP2C19<\/jats:italic>\n                    no\u2010function alleles. While\n                    <jats:italic>CYP2C19<\/jats:italic>\n                    \u2010guided DAPT is well\u2010established for some cardiovascular indications, its use in neurovascular settings has remained limited until recently. This study characterized current implementation strategies for\n                    <jats:italic>CYP2C19<\/jats:italic>\n                    \u2010guided DAPT for neurovascular indications across institutions in the Pharmacogenomics Global Research Network Implementation Working Group. A REDCap survey was distributed to 54 institutions targeting those currently utilizing or planning to implement\n                    <jats:italic>CYP2C19<\/jats:italic>\n                    testing to guide clopidogrel use for neurovascular indications. The survey collected data on implementation status, workflows, testing logistics, clinical decision support (CDS), and guideline concordance. Fifteen institutions met inclusion criteria; 80% were in the United States and 87% were academic centers.\n                    <jats:italic>CYP2C19<\/jats:italic>\n                    testing was used for neurovascular indications at 12 sites, most commonly for AIS, intracranial aneurysm repair, and intracranial stenting. Implementation was often built on infrastructure previously established for cardiovascular indications. Most sites used multigene panels, offered testing in both inpatient and outpatient settings, and returned results within 7\u2009days. Eighty percent of sites provided CDS to support application of results. All sites recommended an alternative P2Y12 inhibitor (e.g., ticagrelor) for poor metabolizers, and most did for intermediate metabolizers.\n                    <jats:italic>CYP2C19<\/jats:italic>\n                    \u2010guided antiplatelet therapy for neurovascular indications is expanding, with many implementations leveraging preexisting infrastructure from cardiovascular settings. Broader adoption and outcome\u2010focused research are needed to optimize the clinical utility of genotype\u2010guided DAPT in neurovascular care.\n                  <\/jats:p>","DOI":"10.1002\/cpt.70402","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T05:01:41Z","timestamp":1785474101000},"page":"937-942","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>\n                      <i>CYP2C19<\/i>\n                    <\/scp>\n                    Genotyping to Guide Clopidogrel Prescribing for Neurovascular Indications: A Survey of Institutional Approaches"],"prefix":"10.1002","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7751-4948","authenticated-orcid":false,"given":"Rachael M.","family":"Stone","sequence":"first","affiliation":[{"name":"University of Virginia  Charlottesville Virginia 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