{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T17:16:08Z","timestamp":1788023768564,"version":"build-2784847793"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cardiovasc Pharmacol Ther"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Platelet reactivity varies after ST-segment-elevation myocardial infarction (STEMI). We evaluated serial platelet function-guided P2Y12 modulation after a 1-month ticagrelor run-in.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>At month 1, 114 patients were randomized to continued ticagrelor (n=59) or an adenosine diphosphate (ADP)-guided strategy (n=55). Month-1 ADP was the preintervention baseline; months 2, 3, 6, 9, and 12 were analyzed using baseline-adjusted generalized estimating equations. Exploratory net adverse clinical events (NACE) were assessed from randomization through month 12 after STEMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the guided group, month-1 ADP was 52 U (range, 4-466); 37 patients received clopidogrel 75 mg and 18 received 150 mg, with 17 dose-threshold discordances. Adjusted postrandomization ADP was higher with the guided strategy (geometric mean ratio, 1.26; 95% confidence interval [CI], 1.05-1.51). NACE occurred in 14\/59 versus 4\/55 patients (risk ratio [RR], 0.31; 95% CI, 0.11-0.87; absolute risk difference, -16.5 percentage points; exact P=.020). Any investigator-classified BARC bleeding occurred in 13\/59 versus 3\/55 (RR, 0.25; 95% CI, 0.07-0.82; exact P=.014), and the post hoc ischemic-or-BARC \u22652 composite in 9\/59 versus 2\/55 (RR, 0.24; 95% CI, 0.05-1.06; exact P=.055). One ischemic event occurred in each group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Serial ADP-guided modulation produced pharmacodynamic separation and was associated with fewer investigator-recorded, bleeding-driven events. Dose-threshold deviations, unverified extreme ADP values, incomplete BARC 2 documentation, and only 2 ischemic events restrict interpretation to hypothesis generation; efficacy and safety cannot be established.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10742484261483397","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:29:11Z","timestamp":1787840951000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Serial Platelet Function-Guided Antiplatelet Modulation After STEMI: A Randomized Pilot Study"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2599-553X","authenticated-orcid":false,"given":"Hrvoje","family":"Jurin","sequence":"first","affiliation":[{"name":"University Hospital Centre Zagreb (UHC 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