{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:32:53Z","timestamp":1761093173333,"version":"build-2065373602"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,7,21]],"date-time":"2021-07-21T00:00:00Z","timestamp":1626825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002489"],"award-info":[{"award-number":["UL1TR002489"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["2\u2010T35AG038047"],"award-info":[{"award-number":["2\u2010T35AG038047"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL149752"],"award-info":[{"award-number":["R01HL149752"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Study Objective<\/jats:title><jats:p>To compare the clinical effectiveness of genotype\u2010guided P2Y12 inhibitor selection following PCI in older patients (\u226570 years) and younger patients (&lt;70 years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Setting<\/jats:title><jats:p>Single\u2010center, retrospective, cohort study. Risk of major adverse cardiovascular or cerebrovascular events (MACCE), defined as stent thrombosis, ischemic stroke, transient ischemic attack, non\u2010fatal acute coronary syndrome, or cardiovascular death during 12 months after PCI, was compared across genotype and antiplatelet therapy groups by proportional hazards regression in patients \u226570 years and &lt;70 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>1,469 patients who underwent PCI and had <jats:italic>CYP2C19<\/jats:italic> genotype testing at a single academic medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and Main Results<\/jats:title><jats:p>The study population was comprised of 402 (27.4%) \u226570\u00a0years (older group) and 1067 (72.6%) &lt;70\u00a0years (younger group). Alternative P2Y12 inhibitors (prasugrel or ticagrelor) were used less often in the older group than the younger group in patients with a <jats:italic>CYP2C19<\/jats:italic> no function allele (55% vs. 67%; <jats:italic>p\u00a0<\/jats:italic>=\u00a00.02) and in patients without a no function allele (10% vs. 35%, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.001). For patients treated with clopidogrel, MACCE was significantly higher in no function allele carriers compared to those without a no function allele in the older group (19.2% vs. 12.7%; adjusted HR 2.32; 95% CI 1.07\u20135.05; <jats:italic>p\u00a0<\/jats:italic>=\u00a00.03) and the younger group (17.4% vs. 10.4%; adjusted HR 2.01; 95% CI 1.17\u20133.46; <jats:italic>p\u00a0<\/jats:italic>=\u00a00.01). In patients without a no function allele, MACCE risk was similar with clopidogrel compared to prasugrel or ticagrelor in the older group (adjusted HR 0.99; 95% CI 0.44\u20132.21; <jats:italic>p\u00a0<\/jats:italic>=\u00a00.98) and the younger group (adjusted HR 1.12; 95% CI 0.72\u20131.74; <jats:italic>p\u00a0<\/jats:italic>=\u00a00.61).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study suggests important clinical benefits of <jats:italic>CYP2C19<\/jats:italic> genotype\u2010guided antiplatelet therapy after PCI in both younger and older patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2611","type":"journal-article","created":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T15:04:08Z","timestamp":1625843048000},"page":"970-977","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effects of aging on clinical outcomes in patients receiving genotype\u2010guided P2Y12 inhibitor 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