{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:03:00Z","timestamp":1785250980239,"version":"3.55.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,5,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Dual\u2010antiplatelet therapy is standard after percutaneous coronary intervention, but clopidogrel responsiveness varies with\n                      <jats:italic toggle=\"no\">CYP2C19<\/jats:italic>\n                      loss\u2010of\u2010function alleles. Whether the genotype conveys different prognostic significance between sexes is uncertain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We analyzed 4630 East\u2010Asian patients with acute coronary syndrome in the PTRG\u2010DES (Platelet Function\u2013 and Genotype\u2010Related Long\u2010Term Prognosis in Drug\u2010Eluting Stent\u2013Treated Patients With Coronary Artery Disease) consortium with available\n                      <jats:italic toggle=\"no\">CYP2C19<\/jats:italic>\n                      genotyping. Patients were classified as rapid\/normal metabolizers versus intermediate\/poor metabolizers. The primary end point was cardiac death, myocardial infarction, or definite stent thrombosis within 5\u2009years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 4630 patients with acute coronary syndrome, 1708 (36.9%) were women. The prevalence of intermediate\/poor metabolizer phenotypes was similar in women (61.8%) and men (62.5%). After multivariable adjustment for clinical, laboratory, and procedural confounders, intermediate\/poor metabolizer carriers had a significantly higher risk of the 5\u2010year primary outcome in men compared with rapid\/normal metabolizer carriers (adjusted hazard ratio [HR], 3.27 [95% CI, 1.58\u20136.74];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.001). In contrast, no significant association was observed in women (adjusted HR, 1.21 [95% CI, 0.58\u20132.52];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      \u2009=\u20090.615). Intermediate\/poor metabolizer status was also associated with a higher risk of 5\u2010year cardiac death in men only (adjusted HR, 7.01 [95% CI, 2.01\u201324.48];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.002). Significant interactions between sex and\n                      <jats:italic toggle=\"no\">CYP2C19<\/jats:italic>\n                      metabolizer status were observed for both the primary outcome (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      for interaction=0.034) and cardiac death (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      for interaction=0.049).\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                      <jats:italic toggle=\"no\">CYP2C19<\/jats:italic>\n                      loss\u2010of\u2010function allele status was a significant predictor of long\u2010term adverse cardiovascular outcomes in men but not in women, suggesting a sex\u2010specific prognostic difference in patients with acute coronary syndrome undergoing percutaneous coronary intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>REGISTRATION<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT04734028.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.045981","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:52:47Z","timestamp":1777369967000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Sex Differences in Prognostic Implications of CYP2C19 Genotype After Drug\u2010Eluting Stent Implantation"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7539-8381","authenticated-orcid":false,"given":"Soo\u2010Jin","family":"Kim","sequence":"first","affiliation":[{"name":"Kosin University College of Medicine","place":["Busan, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9990-6843","authenticated-orcid":false,"given":"Ae\u2010Young","family":"Her","sequence":"additional","affiliation":[{"name":"Kangwon National University School of Medicine","place":["Chuncheon, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1846-8464","authenticated-orcid":false,"given":"Hyung Joon","family":"Joo","sequence":"additional","affiliation":[{"name":"Korea University College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3456-8705","authenticated-orcid":false,"given":"Kiyuk","family":"Chang","sequence":"additional","affiliation":[{"name":"Catholic University of Korea","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2493-066X","authenticated-orcid":false,"given":"Byeong\u2010Keuk","family":"Kim","sequence":"additional","affiliation":[{"name":"Yonsei University College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3986-9152","authenticated-orcid":false,"given":"Young Bin","family":"Song","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1528-2739","authenticated-orcid":false,"given":"Sung Gyun","family":"Ahn","sequence":"additional","affiliation":[{"name":"Yonsei University Wonju Severance Christian Hospital","place":["Wonju, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0397-6071","authenticated-orcid":false,"given":"Jung\u2010Won","family":"Suh","sequence":"additional","affiliation":[{"name":"Seoul National University Bundang Hospital","place":["Seongnam, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1386-349X","authenticated-orcid":false,"given":"Sang Yeup","family":"Lee","sequence":"additional","affiliation":[{"name":"Chung\u2010Ang University College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9803-6612","authenticated-orcid":false,"given":"Jung Rae","family":"Cho","sequence":"additional","affiliation":[{"name":"Hallym University College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0847-5329","authenticated-orcid":false,"given":"Hyo\u2010Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Seoul National University Hospital","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0403-3726","authenticated-orcid":false,"given":"Young\u2010Hoon","family":"Jeong","sequence":"additional","affiliation":[{"name":"Chung\u2010Ang University College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3468-6453","authenticated-orcid":false,"given":"Moo Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Dong\u2010A University Hospital","place":["Busan, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5751-5177","authenticated-orcid":false,"given":"Do\u2010Sun","family":"Lim","sequence":"additional","affiliation":[{"name":"Korea University College of Medicine","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9169-6968","authenticated-orcid":false,"given":"Eun\u2010Seok","family":"Shin","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Ulsan, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-21-00904"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.03.513"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1124\/dmd.109.029132"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.2526"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2021.01.024"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.03.034"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1907096"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.07.022"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.024709"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2022.63.5.413"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2010.05.007"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11033-014-3617-4"},{"key":"e_1_3_1_14_2","first-page":"489","article-title":"The 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