Furthermore, there were no statistically significant differences in bleeding event rates between the two treatment strategies within any metabolic phenotype (all <i>P</i> > 0.05).<h4>Conclusion</h4>Antiplatelet therapy guided by CYP2C19 genotyping is an effective strategy for optimizing the secondary prevention of ischemic stroke. This evidence concerns the gene CYP2C19 and ischemic stroke.