Comparative Effects of Genetic and Nongenetic Factors in Antithrombotic Strategy

[Developing Risk Prediction Models for High Platelet Reactivity] A recent randomized trial showed that a CYP2C19 genotype-guided strategy for oral P2Y12 inhibitor therapy was noninferior to standard treatment at 12 months with respect to thrombotic events and resulted in a lower incidence of bleeding among patients undergoing primary percutaneous coronary intervention (PCI). In addition, recent studies showed that integrating CYP2C19 loss-offunction genotypes with clinical factors that influence P2Y12 inhibitor response may enhance the ability to identify patients at risk of high platelet reactivity (HPR), and thus, appropriate selection of P2Y12 inhibitor therapy is necessary.