{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T20:44:01Z","timestamp":1780778641214,"version":"3.54.1"},"reference-count":70,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,3,5]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Genetic\u2010guided pharmacotherapy (PGx) is not recommended in clinical guidelines for coronary artery disease (CAD). We aimed to examine the extent and quality of evidence from economic evaluations of PGx in CAD and to identify variables influential in changing conclusions on cost\u2010effectiveness.<\/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\">From systematic searches across 6 databases, 2 independent reviewers screened, included, and rated the methodological quality of economic evaluations of PGx testing to guide pharmacotherapy for patients with CAD. Of 35 economic evaluations included, most were model\u2010based cost\u2010utility analyses alone, or alongside cost\u2010effectiveness analyses of PGx testing to stratify patients into antiplatelets (25\/35), statins (2\/35), pain killers (1\/35), or angiotensin\u2010converting enzyme inhibitors (1\/35) to predict CAD risk (8\/35) or to determine the coumadin doses (1\/35). To stratify patients into antiplatelets (96\/151 comparisons with complete findings of PGx versus non\u2010PGx), PGx was more effective and more costly than non\u2010PGx clopidogrel (28\/43) but less costly than non\u2010PGx prasugrel (10\/15) and less costly and less effective than non\u2010PGx ticagrelor (22\/25). To predict CAD risk (51\/151 comparisons), PGx using genetic risk scores was more effective and less costly than clinical risk score (13\/17) but more costly than no risk score (16\/19) or no treatment (9\/9). The remaining comparisons were too few to observe any trend. Mortality risk was the most common variable (47\/294) changing conclusions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Economic evaluations to date found PGx to stratify patients with CAD into antiplatelets or to predict CAD risk to be cost\u2010effective, but findings varied based on the non\u2010PGx comparators, underscoring the importance of considering local practice in deciding whether to adopt PGx.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.030058","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T10:42:41Z","timestamp":1708684961000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Genetic\u2010Guided Pharmacotherapy for Coronary Artery Disease: A Systematic and Critical Review of Economic Evaluations"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2340-4097","authenticated-orcid":false,"given":"Ka Keat","family":"Lim","sequence":"first","affiliation":[{"name":"School of Life Course &amp; Population Sciences Faculty of Life Sciences &amp; Medicine, King\u2019s College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8924-4671","authenticated-orcid":false,"given":"Rositsa","family":"Koleva\u2010Kolarova","sequence":"additional","affiliation":[{"name":"Health Economics Research Centre, Nuffield Department of Population Health University of Oxford Oxford United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4926-5232","authenticated-orcid":false,"given":"Hanin Farhana","family":"Kamaruzaman","sequence":"additional","affiliation":[{"name":"Health Economics and Health Technology Assessment (HEHTA), School of Health and Wellbeing University of Glasgow Glasgow United Kingdom"},{"name":"Malaysian Health Technology Assessment Section (MaHTAS), Medical Development Division, Ministry of Health Putrajaya Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7532-5158","authenticated-orcid":false,"given":"Ahmad Amir","family":"Kamil","sequence":"additional","affiliation":[{"name":"School of Life Course &amp; Population Sciences Faculty of Life Sciences &amp; Medicine, King\u2019s College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4507-038X","authenticated-orcid":false,"given":"Phil","family":"Chowienczyk","sequence":"additional","affiliation":[{"name":"School of Life Course &amp; Population Sciences Faculty of Life Sciences &amp; Medicine, King\u2019s College London London United Kingdom"},{"name":"King\u2019s College London British Heart Foundation Centre St. Thomas\u2019 Hospital, Westminster Bridge London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8264-0981","authenticated-orcid":false,"given":"Charles D. 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