Acute Myocardial Infarction Clinical Trial
Official title:
Platelet Inhibition in the Acute Phase of ST-segment Elevation Myocardial Infarction
Background:
Dual antithrombotic treatment with aspirin and clopidogrel is recommended in patients with
ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary
intervention (PCI). The European Society of Cardiology (ESC) Guidelines recommend a bolus
dose of aspirin of 250-500 mg and a 600 mg bolus dose of clopidogrel as soon as STEMI is
suspected. Studies have shown that more newly produced platelets are present in the acute
phase of STEMI, and it is likely that these immature platelets are haemostatically more
active and might be of importance in thrombus formation.
The enhanced platelet reactivity may reduce the effect of aspirin and clopidogrel in the
acute phase of STEMI compared to measurements made in the same patients 3 months after
primary PCI.
Aim:
This study aims to compare platelet response to aspirin and clopidogrel in the acute phase
of STEMI with the platelet response in the same patients 3 months after STEMI .
Design:
This study is an observational follow-up study.
Materials and methods:
46 patients with STEMI referred to primary PCI at Aarhus University Hospital, Skejby will be
included in the study. A total of 3 blood samples are obtained in the acute phase of STEMI:
Prior to primary PCI (Blood sample 1), at 4 hours (Blood sample 2) and at 12 hours (Blood
sample 3) after administration of loading dose aspirin and clopidogrel. When patients are in
a stable phase 3 month later, a final blood sample is taken (Blood sample 4). The blood is
analyzed 30 minutes after withdrawal of blood by the platelet aggregation test Multiplate®
aggregometry (agonists: Collagen, arachidonic acid and adenosinediphosphate) and VerifyNow®
arachidonic acid and P2Y12 aggregometry. Platelet count, volume and the immature platelet
fraction (IPF) will be measured using Sysmex® flowcytometry.
n/a
Observational Model: Case-Only, Time Perspective: Prospective
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