ticagrelor and eptifibatide bolus-only versus ticagrelor and eptifibatide bolus plus abbreviated infusion

Conditions: Acute Coronary Syndrome

Summary: this purpose of this study is to measure platelet response to ticagrelor and eptifibatide bolus-only compared with ticagrelor and eptifibatide bolus plus 2-hour infusion administrated after cardiac catheterization in patients undergoing non-emergent percutaneous coronary intervention.

in this study, 70 patients with acute coronary syndrome who are undergoing non-emergent percutaneous coronary intervention (pci) will be randomized to ticagrelor loading dose and eptifibatide bolus-only versus ticagrelor loading dose and eptifibatide bolus plus 2 hour infusion administrated after cardiac catheterization, but before pci. platelet function testing will be performed at baseline and follow-up.

Eligibility criteria:
inclusion criteria: for inclusion in the study subjects should fulfill the following criteria: * provision of informed consent prior to any study specific procedures * males and females aged 19 years and older * congruent to the plato trial, at least two of the following three criteria have to be met: * st-segment changes on electrocardiography, indicating ischemia; (in electrocardiography, the st segment connects the qrs complex and the t wave and has a duration of 0.080 to 0.120 sec (80 to 120 ms). * a positive test of a biomarker, indicating myocardial necrosis; or one of several risk factors; * age \>60 years * previous myocardial infarction or coronary-artery bypass grafting \[cabg\]; * coronary artery disease with stenosis of ≥50% in at least two vessels; * previous ischemic stroke, transient ischemic attack, carotid stenosis of at least 50%, or cerebral revascularization; * diabetes mellitus; * peripheral arterial disease; * or chronic renal dysfunction, defined as a creatinine clearance of \<60 ml per minute per 1.73 m2 of body surface area). * patients with symptoms of unstable angina lasting ≥10 min and either an elevated troponin i level or newly developed st-segment depression of 1 mm or transient st-segment elevation of 1 mm will also be included. exclusion criteria: subjects should not enter the study if any of the following exclusion criteria are fulfilled: * patients with active pathological bleeding or a history of intracranial bleeding; * patients with planned to urgent coronary artery bypass graft surgery; * severe hepatic impairment; * concomitant therapy with a strong cytochrome p-450 3a inhibitors, where 3a is s subfamily of the cytochrome p450 superfamily of genes; * surgery\<4 weeks; * the use of any thienopyridine (within the previous two weeks); * upstream use of glycoprotein (gp) iib/iiia inhibitors; * bleeding diathesis or major bleeding episode within 2 weeks; * a need for oral anticoagulation therapy; * thrombocytopenia; * presence of thrombus in the coronary artery; incessant chest pain or hemodynamic instability; * and patients with glomerular filtration rate (gfr)\<30 ml/min or on hemodialysis. * maintenance dose of aspirin above 100mg * history of allergies to ticagrelor * patients at increased risk of bradycardic events (e.g., patients who have sick sinus syndrome, 2nd or 3rd degree atrioventricular block (av block), or bradycardic related syncope and not protected with a pacemaker * women who are pregnant or breastfeeding

Keywords: pci ticagrelor eptifibatide