SynthesisJACC. Cardiovascular interventions2021
Effect of CYP2C19 Genotype on Ischemic Outcomes During Oral P2Y
Synthesis in JACC. Cardiovascular interventions, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 9 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
77 citing papers in PubMed, 9 syntheses or guidelines pooled it, 159 citations in OpenAlex.
- Interaction of CYP2C19 with the effect of clopidogrel in secondary prevention of major ischemic events: Systematic review and meta-analysis.International journal of stroke : official journal of the International Stroke Society · 2026Pooled it
- Comparison between clopidogrel and ticagrelor in CYP2C19 loss-of-function alleles coronary artery disease and stroke patients: a meta-analysis.European journal of clinical pharmacology · 2025Pooled it
- Risk of major adverse cardiovascular events in CYP2C19 LoF genotype guided clopidogrel against alternative antiplatelets for CAD patients undergoing PCI: Meta-analysis.Clinical and translational science · 2025Pooled it
- Pooled it
- Pooled it
- Accuracy and technical characteristics of CYP2C19 point of care tests: a systematic review.Pharmacogenomics · 2024Pooled it
- Antithrombotic therapy for secondary prevention of unprovoked venous thromboembolism: a systematic review and network meta-analysis of randomized controlled trials.Annals of medicine · 2022Pooled it
- The role ofExpert review of clinical pharmacology · 2022Pooled it
- Effect of CYP2C19 genetic polymorphism on the pharmacodynamics and clinical outcomes for patients treated with ticagrelor: a systematic review with qualitative and quantitative meta-analysis.BMC cardiovascular disorders · 2022Pooled it
- Machine Learning With Genetic and Clinical Data to Predict Ischemic Outcomes After PCI.Clinical and translational science · 2026Trial
- Cost analysis of CYP2C19 genetic testing in percutaneous coronary intervention patients.The pharmacogenomics journal · 2024Trial
- Safety and Efficacy of CYP2C19 Genotype-Guided Escalation of P2YCardiovascular drugs and therapy · 2024Trial
- Genetic-Guided Oral P2YJACC. Cardiovascular interventions · 2023Trial
- Sex-Specific Differences in Clinical Outcomes After Percutaneous Coronary Intervention: Insights from the TAILOR-PCI Trial.Journal of the American Heart Association · 2022Trial
- ABCD-GENE Score and Clinical Outcomes Following Percutaneous Coronary Intervention: Insights from the TAILOR-PCI Trial.Journal of the American Heart Association · 2022Trial
- Genotype-Guided P2YCirculation. Genomic and precision medicine · 2021Trial
- CYP2C19 Genotyping to Guide Clopidogrel Prescribing for Neurovascular Indications: A Survey of Institutional Approaches.Clinical pharmacology and therapeutics · 2026Article
- Residual cardiovascular risk in coronary artery disease: from pathophysiology to established and novel therapies.Nature reviews. Cardiology · 2026Review
- Selphi, a tool for improving genotype imputation accuracy.Scientific reports · 2026Article
- 2025 Acute Coronary Syndrome Guideline: Missing the Boat onJournal of the American Heart Association · 2026Review
17 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
15 authors at 6 institutions in 2 countries.
Funding
Abstract
objectivesThe aim of this study was to examine the effect of CYP2C19 genotype on clinical outcomes in patients with coronary artery disease (CAD) who predominantly underwent percutaneous coronary intervention (PCI), comparing those treated with ticagrelor or prasugrel versus clopidogrel.
backgroundThe effect of CYP2C19 genotype on treatment outcomes with ticagrelor or prasugrel compared with clopidogrel is unclear.
methodsDatabases through February 19, 2020, were searched for studies reporting the effect of CYP2C19 genotype on ischemic outcomes during ticagrelor or prasugrel versus clopidogrel treatment. Study eligibility required outcomes reported for CYP2C19 genotype status and clopidogrel and alternative P2Y
resultsOf 1,335 studies identified, 7 RCTs were included (15,949 patients, mean age 62 years; 77% had PCI, 98% had acute coronary syndromes). Statistical heterogeneity was minimal, and risk for bias was low. Ticagrelor and prasugrel compared with clopidogrel resulted in a significant reduction in ischemic events (relative risk: 0.70; 95% confidence interval: 0.59 to 0.83) in CYP2C19 loss-of-function carriers but not in noncarriers (relative risk: 1.0; 95% confidence interval: 0.80 to 1.25). The test of interaction on the basis of CYP2C19 genotype status was statistically significant (p = 0.013), suggesting that CYP2C19 genotype modified the effect. An additional 4 observational studies were found, and adding them to the analysis provided the same conclusions (p value of the test of interaction <0.001).
conclusionsThe effect of ticagrelor or prasugrel compared with clopidogrel in reducing ischemic events in patients with CAD who predominantly undergo PCI is based primarily on the presence of CYP2C19 loss-of-function carrier status. These results support genetic testing prior to prescribing P2Y
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.