Genotyping GUided Antiplatelet theRapy in pAtieNts Treated With Drug Eluting stEnts (GUARANTEE)

Prior treatment

• Patient having received thrombolytic therapy within the previous 24 hours
• Patient is receiving chronic oral anticoagulation therapy (i.e., vitamin K antagonist, direct thrombin inhibitor, Factor Xa inhibitor)

Other illness

• Patient developing procedure-related complications such as stent thrombosis, coronary dissection, coronary perforation, cardiac tamponade or no-reflow during PCI
• Contraindicated or allergic to clopidogrel or ticagrelor
• History of intracranial hemorrhage
• Patient has a history of bleeding diathesis or coagulopathy
• Patient has an active pathological bleeding, such as active gastrointestinal (GI) bleeding
• Patient with active liver diseases
• Patient has a malignancy or a life expectancy of less than one year

Lab values

• Patient unable to receive 12 months of dual anti-platelet therapy
• Anticipated discontinuation of dual anti-platelet therapy within the 12-month follow-up period, example for elective surgery
• Patient with LVEF \<30%
• Patient with severe renal insufficiency (eGFR \<30ml/min/1.73m2 based on simplified MDRD equation or CrCl \<30ml/min based on Cockcroft-Gault equation)
• Platelet count \<100 000/μL, or hematocrit \<32% or \>52%, or white blood cell count \<3000/μL

Other

• Patient or physician refusal to enroll in the study
• Physician has known the patient's CYP2C19 genotype
• Patient is pregnant, breastfeeding, or planning to become pregnant within 12 months
• Patient with cardiogenic shock or mechanical circulatory assist devices placed

• Patient ≥18 years of age
• Patient presents with acute coronary syndrome (ACS) or stable coronary artery disease (SCAD)
• Patient has a percutaneous coronary intervention (PCI) indication and the new generation drug eluting stent(s) is successfully implanted