Cardiac Arrest Clinical Trial
Official title:
Comparison of Antiplatelet Therapy With Clopidogrel and Ticagrelor in Patients After Cardiac Arrest Treated With Therapeutic Hypothermia
There is growing evidence that standard dual antiplatelet therapy with acetylsalicylic acid
(ASA) and clopidogrel is not as effective in the setting of therapeutic hypothermia after
cardiac arrest as in normothermic patients. The reasons for this are probably slower
gastrointestinal motility, absorption and liver metabolism required for clopidogrel to take
action. Since ticagrelor has faster intestinal absorption and no need for liver metabolism we
expect its effect to be good even in patients with therapeutic hypothermia after cardiac
arrest. Patients treated with therapeutic hypothermia after cardiac arrest and percutaneous
coronary intervention will be randomised into two groups. One will be treated with ASA and
clopidogrel and the other with ASA and ticagrelor. Blood samples will be collected before and
2, 4, 12, 22 and 48 hours after P2Y12 inhibitor administration. Platelet function will be
measured by VerifyNow P2Y12 assay and by Multiplate ADPTest. Differences between the groups
will be analysed.
Hypothesis: Antiplatelet therapy with ticagrelor is more effective than therapy with
clopidogrel in the comatose survivors of cardiac arrest treated with therapeutic hypothermia
and percutaneous coronary intervention (PCI).
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