Key result
Thrombelastogram-guided antiplatelet therapy significantly reduced stroke recurrence (4.26% vs 20.00%) and bleeding incidents compared to conventional therapy in patients with acute non-cardiogenic stroke.
Why the study?
To investigate the value of using thrombelastogram detection of platelet inhibition rate to guide antiplatelet therapy in acute non-cardiogenic stroke.
Does TEG-guided antiplatelet therapy improve clinical outcomes and reduce stroke recurrence and hemorrhage in patients with acute non-cardiogenic stroke?
RCT (n=100)
Randomly divided
No
Does TEG-guided antiplatelet therapy improve clinical outcomes and reduce stroke recurrence and hemorrhage in patients with acute non-cardiogenic stroke?
Absolute Event Rate: 4.26% vs 20%
p-value: p=0.020
TEG-guided antiplatelet therapy in acute non-cardiogenic stroke may improve neurological outcomes and reduce the risk of stroke recurrence and hemorrhage.
TEG may support platelet monitoring in non-cardiogenic stroke; leaves open need for outcome trials before adoption.
Objective: To investigate the application value of thrombelastogram (TEG) in the detection of platelet inhibition rate for antiplatelet therapy for acute non-cardiogenic stroke. Methods: A total of 100 patients with ischemic non-cardiogenic stroke were selected for this study from September 2020 to October 2021. Patients were randomly divided into experimental group and control group, with 50 cases for each group. Before and after 1 week of antiplatelet drug treatment, the platelet inhibition rate in the experimental group was measured with arachidonic acid (AA) and adenosine diphosphate (ADP) by TEG; no platelet inhibition rates detection was conducted for the control group. The dose and type of drugs were adjusted for the experimental group according to the platelet functions and medication based on the clinical experience conducted for the control group. The neurological deficits of the discharged patients were scored with NIHSS score, mRS score, stroke recurrence, hemorrhage, and other events were followed up at the 3rd month of discharge. Results: In the experimental group, the inhibition rates of AA and ADP were significantly higher than those before treatment (both P < 0.05). After treatment, the inhibition rates of AA and ADP in dual antiplatelet patients were higher than those of monoclonal antiplatelets (both P < 0.05). The NIHSS score at discharge and the mRS score at the 3rd-month-follow-up in the experimental group were lower than those in the control group (both P < 0.05). The incidences of stroke recurrence and hemorrhage events in the experimental group were lower than those in the control group (P < 0.05). Conclusion: The application of a thrombelastogram in the detection of platelet inhibition rate to guide antiplatelet therapy in patients with acute non-cardiogenic stroke reduces the recurrences of cerebral infarction and the risk of hemorrhage and improves patients’ clinical prognosis.
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Liu et al. (2022) conducted an RCT in Acute non-cardiogenic stroke (n=100). Thrombelastogram (TEG)-guided antiplatelet therapy vs. Conventional antiplatelet therapy based on clinical experience was evaluated on Stroke recurrence at 3 months (p=0.020). Thrombelastogram-guided antiplatelet therapy significantly reduced stroke recurrence (4.26% vs 20.00%) and bleeding incidents compared to conventional therapy in patients with acute non-cardiogenic stroke.
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