Li X, Qiu M, Na K, et al. - Herein, ticagrelor was compared with clopidogrel with respect to effectiveness as well as safety in acute coronary artery syndrome (ACS) patients stratified by the Optimal Antiplatelet Therapy for Chinese Patients with Coronary Artery Disease (OPT‐CAD) risk score. This study involved 16,343 ACS patients who received percutaneous coronary intervention at the General Hospital of Northern Theater Command and these patients were grouped, based on OPT‐CAD risk score, as low‐risk (n = 9,841) or intermediate‐ to high‐risk (n = 6,502). Ischemic events were assessed at 12 months (primary endpoint). By applying propensity score matching, groups were balanced. Findings revealed that ischemic prognosis in intermediate‐ to high‐risk patients was improved with ticagrelor but it demonstrated worse safety in low‐risk patients relative to clopidogrel, favoring the effectiveness of risk score‐guided decision making.