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Prasugrel Versus Ticagrelor in Patients With CYP2C19 Loss-of-Function Genotypes: Results of a Randomized Pharmacodynamic Study in a Feasibility Investigation of Rapid Genetic Testing (JACC: Basic to Translational Science May 2020)

The feasibility of rapid genetic testing in patients undergoing percutaneous coronary intervention (PCI) and the comparison of the pharmacodynamic effects of prasugrel versus ticagrelor among carriers of cytochrome P450 2C19 loss-of-function alleles treated with PCI has been poorly explored. Rapid genetic testing using the Spartan assay was shown to be feasible and provides results in a timely fashion in a real-world setting of patients undergoing coronary angiography (n = 781). Among patients (n = 223, 28.5%), carriers of at least 1 loss-of-function allele treated with PCI (n = 65), prasugrel, and ticagrelor achieve similar levels of platelet inhibition.


Douglas L. Mann, MD, FACC

CME Editor
L. Kristin Newby, MD, FACC

Michelle Kelsey, MD
Vishal Rao, MD
Amanda Coniglio, MD

CME/MOC/ECME Information

Target Audience
JACC Journal CME/MOC/ECME is intended for physicians who treat patients with cardiovascular disease.

Important Dates
Date of Release: May 25, 2020
Term of Approval/Date of CME/MOC/ECME Expiration: May 24, 2021

Learner Objectives
After reading this article the reader should be able to:

  • Compare the mechanisms of action and pharmacokinetics of P2Y12 receptor antagonists.
  • Identify the genetic alleles relevant to clopidogrel metabolism.
  • Discuss the various indications and cutoffs for fractional flow reserve and instantaneous wave-free ratio testing to guide coronary intervention.

Method of Participation and Claiming Credit
This ACCF JACC Journals CME/MOC/ECME activity includes the reading of an article published in one of the JACC journals and the successful completion of self-assessment questions.  

Requesting AMA PRA Category 1 CME Credit™ and/or MOC or ECME credit for this Activity
To request credit, you must:

  • Read the article for which you wish to receive credit.
  • Answer the self-assessment questions. You need to have achieved a passing score of 70% or better in order for the Evaluation link to become activated. If you did not achieve a passing score, please click on the Posttest link in the left navigation bar and retake the exam.
  • After you complete the Evaluation, click on the Claim Credit button in the left navigation bar.
  • For CME or COP credit, enter the total amount of time you actually spent in the activity in the box provided. Please note that you may only claim once for this activity. Click Claim
  • For MOC credit, click the Claim button in the row for MOC. Please note that you may only claim once for this activity. Confirm your ABIM number and date of birth.
  • For ECME credit, click the Claim button in the row for ECME.  Please note that you may only claim once for this activity.  Enter date of birth and click Submit.  
  • The page will be updated with the date and time that you claimed your credit.
  • To view your credit, or to print a certificate, please go to and navigate to the My Transcript section of My ACC.

This CME/MOC/ECME-certified activity may contain links to other educational resources such as clinical trial summaries, journal articles, guidelines, etc., that may not be CME/MOC/ECME certified. Please note that clicking on the links provided to view these resources will open new windows, which are outside of this CME/MOC/ECME-certified activity.

Availability: On-Demand
Available May 25, 2020 to May 24, 2021
Cost: FREE
Credit Offered: 1 ABIM-MOC Point
1 CME Credit
1 ECME Credit
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