Platelet Reactivity After CABG
| Status: | Completed |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | May 2013 |
| End Date: | September 2015 |
Platelet Activation, Reactivity, and Inflammation After Coronary Bypass Surgery In Patients Treated With Ticagrelor or Clopidogrel
Patients who have a heart attack are regularly treated with either clopidogrel or
ticagrelor. In a large clinical trial, treatment with ticagrelor before coronary bypass
surgery (CABG) was associated with a lower risk of death than treatment with clopidogrel.
The reason for this difference cannot be explained on the basis of the study. One possible
explanation is that the reversible binding of ticagrelor is advantageous because when new
platelets are released, they are inhibited by the drug. Because clopidogrel binds
irreversibly it cannot redistribute. The investigators will recruit patients who are
scheduled for surgery after an acute coronary syndrome who have been treated with either
ticagrelor or clopidogrel. After the patient provides informed consent, the investigators
will review their medical record,record information and on the day after surgery the
investigators will take one sample of blood. That blood will be analyzed for evidence of
platelet activation (platelet microparticles, and platelet-leukocyte aggregates), the
reactivity of young platelets, and the concentration of inflammatory cytokines. The
investigators hypothesize that the evidence of platelet activation (platelet microparticles
and platelet-leukocyte aggregates) and the reactivity of young platelets will be less in
patients who have been treated previously with ticagrelor.
ticagrelor. In a large clinical trial, treatment with ticagrelor before coronary bypass
surgery (CABG) was associated with a lower risk of death than treatment with clopidogrel.
The reason for this difference cannot be explained on the basis of the study. One possible
explanation is that the reversible binding of ticagrelor is advantageous because when new
platelets are released, they are inhibited by the drug. Because clopidogrel binds
irreversibly it cannot redistribute. The investigators will recruit patients who are
scheduled for surgery after an acute coronary syndrome who have been treated with either
ticagrelor or clopidogrel. After the patient provides informed consent, the investigators
will review their medical record,record information and on the day after surgery the
investigators will take one sample of blood. That blood will be analyzed for evidence of
platelet activation (platelet microparticles, and platelet-leukocyte aggregates), the
reactivity of young platelets, and the concentration of inflammatory cytokines. The
investigators hypothesize that the evidence of platelet activation (platelet microparticles
and platelet-leukocyte aggregates) and the reactivity of young platelets will be less in
patients who have been treated previously with ticagrelor.
Inclusion Criteria:
- Acute coronary syndrome, CABG, within 48 hours of last dose of clopidogrel or
ticagrelor, treatment with aspirin
Exclusion Criteria:
- Treatment with an antiplatelet agent other than aspirin, clopidogrel, or ticagrelor,
Acute or chronic hematologic disorder including a preoperative Hgb less than 10 g/dl
or platelet count less than 100,000/mm3, Moderate or severe renal insufficiency
(glomerular filtration rate less than 60 ml/min), Active infection, Active
malignancy, Unable/unwilling to provide informed consent
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