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Approximately 30% of the US population has a <jats:italic>CYP2C19<\/jats:italic> no\u2010function allele that reduces the effectiveness of clopidogrel, but not prasugrel or ticagrelor, after PCI. We have shown improved outcomes with the integration of <jats:italic>CYP2C19<\/jats:italic> genotyping into clinical care to guide the selection of prasugrel or ticagrelor in <jats:italic>CYP2C19<\/jats:italic> no\u2010function allele carriers. However, the influence of patient\u2010specific demographic, clinical, and other genetic factors on outcomes with genotype\u2010guided DAPT has not been defined. In addition, the impact of genotype\u2010guided de\u2010escalation from prasugrel or ticagrelor to clopidogrel in patients without a <jats:italic>CYP2C19<\/jats:italic> no\u2010function allele has not been investigated in a diverse, real\u2010world clinical setting. The Precision Antiplatelet Therapy after Percutaneous Coronary Intervention (Precision PCI) Registry is a multicenter US registry of patients who underwent PCI and clinical <jats:italic>CYP2C19<\/jats:italic> testing. The registry is enrolling a diverse population, assessing atherothrombotic and bleeding events over 12\u2009months, collecting DNA samples, and conducting platelet function testing in a subset of patients. The registry aims to define the influence of African ancestry and other patient\u2010specific factors on clinical outcomes with <jats:italic>CYP2C19<\/jats:italic>\u2010guided DAPT, evaluate the safety and effectiveness of <jats:italic>CYP2C19\u2010<\/jats:italic>guided DAPT de\u2010escalation following PCI in a real\u2010world setting, and identify additional genetic influences of clopidogrel response after PCI, with the ultimate goal of establishing optimal strategies for individualized antiplatelet therapy that improves outcomes in a diverse, real\u2010world population.<\/jats:p>","DOI":"10.1111\/cts.70004","type":"journal-article","created":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T13:44:18Z","timestamp":1723815858000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Precision Antiplatelet Therapy after Percutaneous Coronary Intervention (Precision <scp>PCI<\/scp>) Registry \u2013 Informing optimal antiplatelet strategies"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7184-5292","authenticated-orcid":false,"given":"Larisa H.","family":"Cavallari","sequence":"first","affiliation":[{"name":"Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3595-5301","authenticated-orcid":false,"given":"Craig R.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"},{"name":"Division of Cardiology and McAllister Heart Institute, School of Medicine University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8503-5736","authenticated-orcid":false,"given":"Francesco","family":"Franchi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, College of Medicine\u2010Jacksonville University of Florida  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2915-4751","authenticated-orcid":false,"given":"Ellen C.","family":"Keeley","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, College of Medicine University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7209-4348","authenticated-orcid":false,"given":"Joseph S.","family":"Rossi","sequence":"additional","affiliation":[{"name":"Division of Cardiology and McAllister Heart Institute, School of Medicine University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5040-2313","authenticated-orcid":false,"given":"Cameron D.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8218-1620","authenticated-orcid":false,"given":"Yan","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6393-7288","authenticated-orcid":false,"given":"Caitrin W.","family":"McDonough","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8992-1230","authenticated-orcid":false,"given":"Petr","family":"Starostik","sequence":"additional","affiliation":[{"name":"Department of Pathology, Immunology and Laboratory Medicine; 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