Key result
DAPT in STEMI links to a ~46% increase in CT-EXTEM, except with genetic resistance.
Why the study?
Evaluating antiplatelet resistance and personalizing therapy using genetic characteristics is critical to improving treatment efficacy and preventing recurrent cardiovascular complications in STEMI.
Does rotation thromboelastometry better assess platelet hemostasis and genetic resistance to dual antiplatelet therapy compared to aggregometry in STEMI patients?
Population
46 patients with STEMI who underwent PCI in the infarct-related artery territory
Comparison
Aspirin + clopidogrel vs aspirin + ticagrelor, and presence vs absence of genetic resistance factors
Design
Observational cohort study
Authors
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CT-EXTEM may detect genetic resistance in STEMI via absent response; hypothesis-generating and should not yet change practice.
Observational (n=46)
Does rotation thromboelastometry better assess platelet hemostasis and genetic resistance to dual antiplatelet therapy compared to aggregometry in STEMI patients?
Absolute Event Rate: 96.3% vs 66.1%
p-value: p=0.02
Rotation thromboelastometry (CT-EXTEM), rather than standard aggregometry, effectively assesses platelet hemostasis and identifies genetic resistance to antiplatelet therapy in STEMI patients.
Markhulia et al. (2025) conducted an observational in ST-segment elevation acute coronary syndrome (STEMI) (n=46). Dual antiplatelet therapy (aspirin + clopidogrel or aspirin + ticagrelor) vs. Baseline (research point 1) was evaluated on CT-EXTEM parameter (p=0.02). In STEMI patients on antiplatelet therapy, the CT-EXTEM parameter significantly increased from baseline (96.3 vs 66.1 s, p=0.02), except in those with genetic resistance.
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