Multimarker Evaluation of Platelet Activity and Agregation in ACS

In this prospective, single-center, observational study, adult patients meeting the inclusion/exclusion criteria were included. Subjects enrolled at the Invasive Cardiology Unit of the 1st Department of Cardiology; Medical University of Warsaw (Poland) were cathegorized into three arms: 1) treated with aspirin and clopidogrel, 2) treated with aspirin and ticagrelor; 3) treated with aspirin and prasugrel. In all three groups subjects first obtained the loading dose of the drug and thereafter they received a fixed daily dose.

Blood samples were collected form each patient at two time-points: during the first 24 hours from hospital admission and after 72 hours following hospital admission. The parameters measured included selected platelet-derived microRNAs prticles, immature platelet fraction (IPF) and platelet microvesicles' comncentration. Platelet reactivity was established using Multiplate® Analyzer (Roche).

Inclusion criteria

• Ability to provide written informed consent in a time window 1-24 hours after successful PCI;
• Male or female, age ≥ 18 years at screening;
• ACS at the time of the index hospitalization;
• ACS patients undergoing PCI (New-Generation DES)
• Use of a loading dose of P2Y12 inhibitor administered after diagnosis of ACS or after PCI;

Exclusion criteria

• Unstable clinical status (hemodynamic or electrical instability);
• Planned surgery requiring DAPT discontinuation during the study;
• Coronary Revascularization (Surgical or Intervention) Program within 90 days
• Prior stroke, transient ischemic attack or intracranial bleeding;
• Active bleeding;
• Severe anemia (hemoglobin < 8g/dL);
• Platelet count ≤70x10^3/ml;
• Hematocrit of < 30% or > 52%
• Renal failure (hemodialysis or creatinine clearance ≤ 30 ml/min calculated with Cockroft-Gault formula);
• Severe hepatic dysfunction (baseline alanine aminotransferase ≥ 2.5 times the upper limit of normal);
• Known hypersensitivity or contraindication to ASA, clopidogrel, ticagrelor or prasugrel;
• Under judicial protection, tutorship or curatorship;
• Pregnancy;
• Unable to understand and follow study-related instructions;
• Enrollment in another investigational device or drug study.
• Unable to provide an informed consent.