Pharmacodynamic Evaluation of Antiplatelet Effect of Swallowing Versus Chewing Ticagrelor in Patients With Acute Coronary Syndrome

Inclusion Criteria: * All patients presenting to the emergency department with acute coronary syndrome for percutaneous coronary intervention Exclusion Criteria: * Age \<18 years * Known coagulopathy, bleeding diathesis, or active bleeding * History of recent gastrointestinal or genitourinary bleeding within 2 months * Previous therapy with clopidogrel, prasugrel, or ticagrelor * Previous treatment with glycoprotein IIb/IIIa inhibitors or during interventional procedure * Major surgery within 6 weeks * History of intracranial bleeding or intracraneal neoplasm * Suspected aortic dissection * Chronic obstructive pulmonary disease * Severe hemodynamic instability or cardiogenic shock * Resuscitated cardiac arrest * Use of vitamin K anticoagulants or novel oral anticoagulants (NOACs) within 7 days * Life expectancy \<1 year * Known severe liver or renal disease, GFR estimated by CKD-EPI \<30 ml/min/1.73 m2 * Known HIV treatment * Hemoglobin \<10 g/dL * Platelet count \<100,000/L * Pregnancy * Known allergy to ticagrelor * Refusal to sign informed consent