Immediate potent inhibition of platelet function is critical for the prevention of periprocedural ischemic event occurrences in high risk N-ST segment elevation myocardial infarction (NSTEMI) in patients undergoing percutaneous coronary intervention (PCI). Currently, dual antiplatelet therapy with aspirin and an oral P2Y12 receptor blocker (with loading doses) is widely used for PCI. However, immediate, potent and reversible inhibition of platelet aggregation is not possible even with the newer oral agents, prasugrel and ticagrelor. Therefore, an intravenously administered GPIIb/IIIa receptor inhibitor (tirofiban) or P2Y12 receptor blocker (cangrelor) with fast onset and offset of actions will provide more desired antiplatelet effects in the setting of PCI. This study will measure and compare the anti-platelet effects of Tirofiban and Cangrelor in patients presenting with N-STEMI and undergoing PCI.
Study Type
OBSERVATIONAL
Enrollment
10
Patients will receive Tirofiban during the PCI procedure
Patients will receive Cangrelor during the PCI procedure
Inova Health Care System
Falls Church, Virginia, United States
Thrombin Receptor Activator Peptide (TRAP) Induced Platelet Aggregation (%)
Assessment of platelet aggregation (%) in response to 10uM thrombin receptor activator peptide. Normal reference range is 60-100% aggregation.
Time frame: 30 minutes post-start of the infusion
Adenosine Diphosphate (ADP) Induced Platelet Aggregation (%)
Assessment of platelet aggregation (%) in response to 20uM ADP at baseline and serially following tirofiban or cangrelor infusion. Normal reference range is 60-100% aggregation.
Time frame: 30 minutes post-start of the infusion
Thrombin Induced Platelet-fibrin Clot Strength (mm)
Assessment of thrombin induced platelet-fibrin clot strength (mm) by thromboelastography (TEG6S). Normal reference range is 55-68 mm
Time frame: 30 minutes post-start of the infusion
Shear-induced Thrombus Formation (AUC)
Real time evaluation of shear-induced thrombus formation using novel RUO T-TAS plus system. AUC is calculated as time to reach 60 kPa
Time frame: 30 minutes after the end of the infusion.
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