The ACS Ethnicity Platelet Function Study

Inclusion criteria

• Female (post menopausal or surgically sterile) and/or male aged 18 years or older
• Presenting with ACS fulfilling the following:

• Symptoms or new ECG changes (ST segment elevation or depression of at least 1 mm in 2 or more contiguous leads on EKG)
• Elevation of biomarkers (CK-MB ≥2 ULN or troponin ≥ ULN)
• Self-identified as African-American
• Treatment with 75-100mg ASA daily

Exclusion criteria

• Any indication (atrial fibrillation, mitral stenosis or prosthetic heart valve, PE, DVT) for antithrombotic treatment during study period.
• Fibrinolytic therapy within 48 hours before randomization
• Concomitant therapy with a drug having possible interaction with ticagrelor. (concomitant therapy with a strong cytochrome P-450 3A inhibitor or inducer)
• Increased bleeding risk including: recent (<30 days) GI bleeding, any history of intracranial, intraocular, retroperitoneal, or spinal bleeding, recent (<30 days of dosing) major trauma, sustained uncontrolled hypertension (systolic blood pressure [SBP]>180mmHg or diastolic blood pressure [DBP]>100mmHg), history of hemorrhagic disorders that can increase the risk of bleeding, platelet count less than 100,000 mm3 or hemoglobin <10 g/dL.
• Any history of hemorrhagic stroke.
• Contraindication or other reason that ASA or ticagrelor should not be administered (e.g., hypersensitivity, active bleeding, major surgery within 30 days of dosing).
• Severe renal failure (creatinine clearance <30mL/min or patient requires dialysis)
• History of moderate or severe hepatic impairment with aspartate amino transferace, alanine amino transferase or total bilirubin > 1.5 x upper limit of the reference range.
• Pregnant or lactating women.
• Patients receiving any glycoprotein IIb/IIIa inhibitors <8 hours before platelet reactivity testing.