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OBJECTIVE: Cardiovascular events prognosis based on CYP2C19 gene polymorphisms had many applications in clinical practice. Assessed characteristics and predictive performance of cardiovascular events in acute coronary syndrome patients with CYP2C19 gene polymorphisms. PATIENTS AND METHODS: The patients were analyzed for CYP2C19 gene polymorphisms by real-time polymerase chain reaction (PCR). The PCR worked with primers around the mutant, as well as two fluorescent probes, one specific for the normal allele and the other for the mutant allele, and cardiovascular events were followed at 3 months and 6 months. RESULTS: Patients with CYP2C19 gene polymorphism accounted for 48.6% of which CYP2C19 *1/*2 genotype had the highest proportion (31.7%). The normal metabolizer phenotype was the majority (51.4%), and the *1 allele proportion accounted for the most (72.2%). Patients with type 2 diabetes (HR: 3.082, 95% CI: 1.652-5.747, p < 0.001) and ST-segment elevation myocardial infarction (HR: 2.874, 95% CI: 1.528-5.404, p = 0.001) were independent prognostic factors for cardiovascular events at 90 days. Type 2 diabetes was an independent prognostic factor for cardiovascular events at 180 days (HR: 3.714, 95% CI: 1.557-8.862, p = 0.003). The CYP2C19 gene polymorphism was an independent prognostic factor of cardiovascular events at 90 days (HR: 1.965, 95% CI: 1.012-3.814, p = 0.046). However, at 180 days of analysis, the association between the CYP2C19 gene polymorphism was not significant (HR: 2.234, 95% CI: 0.862-5.789, p = 0.098). CONCLUSIONS: CYP2C19 gene polymorphism was an independent prognostic factor of cardiovascular events 90 days after acute coronary syndrome. [ABSTRACT FROM AUTHOR]