Abstract I have built a successful patient oriented research program focused on pharmacogenomics, pharmacoepidemiology, and chronic disease epidemiology with a focus on cardiovascular diseases. My research goal is to elucidate the role of clinical, environmental and genetic factors on variability in cardiovascular disease risk and response to medications and to use this information to tailor treatments, especially in patients with multiple comorbidities. The proposed award would enable me to continue mentoring while expanding my research program specifically incorporating implementation science tools to address key translational knowledge gaps. The new research proposed herein is builds on ongoing work to create unique and much needed patient oriented research (POR) training opportunities in cardiovascular pharmacotherapeutics and improvement in risk prediction by incorporating genomic information. My NIH grants along with the four new projects will form the basis for the mentee (MD, Pharm.D, and PhD) training. Mentorship aims expand the POR training opportunities for trainees. Mentees will lead the new projects, develop skills related to discovery and implementation, conduct analysis and publish original research. They will leverage this to propose new research as part of their NIH- K23 applications. PROJECT1 will elucidate the differential effect of sex and age on gene-hemorrhage association among anticoagulant users. PROJECT 2 will evaluate the influence of pharmacogenetic variants on Apixaban and Rivaroxaban pharmacokinetics and pharmacodynamics. PROJECT 3 will evaluate the performance of bleeding risk scores and the integration of genetics in risk prediction among patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). PROJECT 4 will evaluate the influence of heart failure on outcomes among patients with ACS undergoing PCI. In the supportive and collaborative environment of UAB, this award will ensure that I continue to grow my research program expand to include hybrid implementation-effectiveness designs and build capacity in POR by mentoring junior investigators to build their own careers. The breadth and depth of the multiple NIH- funded institutional training programs, UAB’s CTSA and her leadership in UAB’s Translational Pharmacogenomics and Precision Medicine Institute will provide the resources and the foundation to advance discovery and implementation efforts to enable translation of research discoveries into clinical care.