{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,8]],"date-time":"2026-11-08T00:55:32Z","timestamp":1794099332739,"version":"4.8.0"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,2,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Studies have demonstrated increased risk of major atherothrombotic events in\n              <jats:italic>CYP2C19<\/jats:italic>\n              loss\u2010of\u2010function (LOF) variant carriers versus non\u2010carriers treated with clopidogrel after percutaneous coronary intervention (PCI). We sought to evaluate real\u2010world outcomes with the clinical implementation of\n              <jats:italic>CYP2C19<\/jats:italic>\n              \u2010guided antiplatelet therapy after PCI.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Data from 9 medical centers where genotyping was performed in the setting of PCI were included. Alternative therapy with prasugrel or ticagrelor was recommended for patients with a\n              <jats:italic>CYP2C19<\/jats:italic>\n              LOF variant. The primary outcome was the composite of major atherothrombotic events (all\u2010cause death, myocardial infarction, ischemic stroke, stent thrombosis, or hospitalization for unstable angina) within 12\u00a0months following PCI. Moderate or severe\/life\u2010threatening bleeding within 12\u00a0months was a secondary outcome. Among 3342 patients, 1032 (31%) were LOF carriers, of whom 571\/1032 (55%) were treated with alternative therapy. In LOF carriers, the rate of major atherothrombotic events was lower in patients treated with alternative therapy versus clopidogrel (adjusted HR, 0.56; 95% CI 0.39\u20130.82). In those without a LOF allele, no difference was observed (adjusted HR, 1.07; 95% CI 0.71\u20131.60). There was no difference in bleeding with alternative therapy versus clopidogrel in either LOF carriers or those without a LOF allele.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Real\u2010world data demonstrate lower atherothrombotic risk in\n              <jats:italic>CYP2C19<\/jats:italic>\n              LOF carriers treated with alternative therapy versus clopidogrel and similar risk in those without a LOF allele treated with clopidogrel or alternative therapy. These data suggest that PCI patients treated with clopidogrel should undergo genotyping so that\n              <jats:italic>CYP2C19<\/jats:italic>\n              LOF carriers can be identified and treated with alternative therapy.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.024159","type":"journal-article","created":{"date-parts":[[2022,2,12]],"date-time":"2022-02-12T10:58:52Z","timestamp":1644663532000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":67,"title":["<i>CYP2C19<\/i>\n            Genotype\u2010Guided Antiplatelet Therapy After Percutaneous Coronary Intervention in Diverse Clinical Settings"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0958-7197","authenticated-orcid":false,"given":"Amber L.","family":"Beitelshees","sequence":"first","affiliation":[{"name":"Department of Medicine and Program for Personalized and Genomic Medicine University of 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