{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T07:03:56Z","timestamp":1789715036778,"version":"4.0.1"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,5,19]]},"abstract":"<jats:p xml:lang=\"en\">\n                    The 2025 American College of Cardiology\/American Heart Association\/American College of Emergency Physicians\/National Association of Emergency Medical Services Physicians\/Society for Cardiovascular Angiography &amp; Interventions acute coronary syndrome guideline focuses on strategies to reduce bleeding risk with antiplatelet therapy yet lacks any recommendation related to\n                    <jats:italic toggle=\"no\">CYP2C19<\/jats:italic>\n                    genotyping. The impact of\n                    <jats:italic toggle=\"no\">CYP2C19<\/jats:italic>\n                    loss\u2010of\u2010function alleles on the effectiveness of clopidogrel is well documented, and although prasugrel and ticagrelor more effectively reduce the risk for atherothrombotic events compared with clopidogrel in patients with a\n                    <jats:italic toggle=\"no\">CYP2C19<\/jats:italic>\n                    loss\u2010of\u2010function allele, clopidogrel reduces bleeding risk without an increase in atherothrombotic events compared with prasugrel or ticagrelor in those without a loss\u2010of\u2010function allele. Accordingly, an American Heart Association Scientific Statement supports\n                    <jats:italic toggle=\"no\">CYP2C19<\/jats:italic>\n                    genetic testing before oral P2Y\n                    <jats:sub>12<\/jats:sub>\n                    inhibitors are prescribed. This commentary summarizes the evidence in support of\n                    <jats:italic toggle=\"no\">CYP2C19<\/jats:italic>\n                    \u2010guided P2Y\n                    <jats:sub>12<\/jats:sub>\n                    inhibitor selection in the context of other 2025 acute coronary syndrome guideline recommendations and urges future guidelines to incorporate recommendations for\n                    <jats:italic toggle=\"no\">CYP2C19<\/jats:italic>\n                    genotyping, especially for those at high bleeding risk.\n                  <\/jats:p>","DOI":"10.1161\/jaha.125.047768","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T09:09:18Z","timestamp":1778058558000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["2025 Acute Coronary Syndrome Guideline: Missing the Boat on\n                    <i>CYP2C19<\/i>\n                    Genotyping"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7184-5292","authenticated-orcid":false,"given":"Larisa H.","family":"Cavallari","sequence":"first","affiliation":[{"name":"University of Florida","place":["Gainesville, 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":"University of North Carolina at Chapel Hill","place":["Chapel Hill, USA"]},{"name":"University of North Carolina at Chapel Hill","place":["Chapel Hill, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0958-7197","authenticated-orcid":false,"given":"Amber L.","family":"Beitelshees","sequence":"additional","affiliation":[{"name":"Department of Medicine and Program for Personalized and Genomic Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3639-717X","authenticated-orcid":false,"given":"Jasmine A.","family":"Luzum","sequence":"additional","affiliation":[{"name":"University of Michigan College of Pharmacy","place":["Ann Arbor, USA"]},{"name":"Henry Ford Health System","place":["Detroit, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8208-8998","authenticated-orcid":false,"given":"George A.","family":"Stouffer","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill","place":["Chapel Hill, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5192-886X","authenticated-orcid":false,"given":"Jurri\u00ebn M.","family":"ten Berg","sequence":"additional","affiliation":[{"name":"St Antonius Hospital","place":["Nieuwegein, the Netherlands"]},{"name":"Cardiovascular Research Institute Maastricht","place":["Maastricht, the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4083-9957","authenticated-orcid":false,"given":"Wout W. A.","family":"van den Broek","sequence":"additional","affiliation":[{"name":"St Antonius Hospital","place":["Nieuwegein, the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3813-3469","authenticated-orcid":false,"given":"Naveen L.","family":"Pereira","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0698-2696","authenticated-orcid":false,"given":"Dirk","family":"Sibbing","sequence":"additional","affiliation":[{"name":"Ludwig\u2010Maximilians\u2010Universit\u00e4t M\u00fcnchen, Munich, Germany and DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8451-2131","authenticated-orcid":false,"given":"Dominick J.","family":"Angiolillo","sequence":"additional","affiliation":[{"name":"University of Florida","place":["Jacksonville, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001309"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.2526"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.06.038"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001257"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2024.08.027"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx175"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01445-8"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00533-X"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcvp\/pvab068"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1907096"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2024.06.020"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2021.01.024"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab836"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac829"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31323-X"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32155-4"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.12443"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.007"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000513"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2025.05.006"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.047768","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T06:37:07Z","timestamp":1789713427000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.047768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,19]]},"references-count":20,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,5,19]]}},"alternative-id":["10.1161\/JAHA.125.047768"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.047768","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,19]]},"assertion":[{"value":"2026-05-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e047768"}}