{"Based on the genotype result, this patient is predicted to be a CYP2C19 intermediate metabolizer. Avoid standard dose clopidogrel (75 mg) if possible due to the risk of therapeutic failure in patients that had a recent acute coronary syndrome and/or a percutaneous coronary intervention, or a neurovascular indication for clopidogrel. Consider use of an alternative antiplatelet agent at standard dose if no contraindication. Prasugrel is contraindicated in patients with a history of transient ischemic attack or stroke. Please consult a clinical pharmacist for more information."}