Platelet Function in Resuscitated Patients

Study Overview
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Brief Summary
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Approx. 65% of resuscitated patients at the intensive care unit for internal medicine are due to myocardial infarction. Almost all patients are initially diagnosed and treated in the cath lab. Therapy usually consists of one or more stent implantations. After implantation of a coronary stent, dual platelet inhibition is necessary for 12 months. Insufficient platelet inhibition causes an pronounced increase in risk of stent thrombosis. Therefore, knowledge of the individual platelet function is valuable. Several factors potentially promote a delayed or reduced mode of action of platelet function inhibitors in resuscitated patients: oral administration is impossible and medication needs to be administered via a gastric line. gastric absorption is delayed after resuscitation according to current guidelines patients are treated with therapeutic hypothermia. Including the time of rewarming cooling period is  48h

Detailed Description
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Patients after successful resuscitation associated to a myocardial infarction will be included into the study the morning after the index event. Patients get dual platelet inhibition at the discretion of the interventionist. Patients are treated with therapeutic hypothermia according to the local Standard operating procedure for 24h and rewarming is performed within an additional 20h. Platelet function is measured every morning and Aspirin mediated as well as P2Y12 (purinergic G protein-coupled receptors-12)-inhibition mediated platelet function inhibition is recorded. All relevant clinical data including APACHE (Acute Physiology and Chronic Health Evaluation) and SOFA ( Sequential Organ Failure Assessment score) scores are collected. The degree of platelet inhibition over time (7 days) and differences between the three drugs tested will be evaluated by optical aggregometry and by using the commercial VerifyNow test system.

Official Title
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Platelet Function in Resuscitated Patients

Conditions
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Acute ST Segment Elevation Myocardial Infarction

Intervention / Treatment
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* Other: diagnostic analysis of platelet function


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Myocardial infarction dual platelet inhibition resuscitation therapeutic hypothermia Exclusion Criteria: none

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| non-resuscitated myocardial infarction<br>diagnostic analysis of platelet function of a matched historical cohort of the ATLANTIS-ACS trial | Other: diagnostic analysis of platelet function<br>* analysis of platelet aggregation using optical measurements as well as the commercial VerifyNow technique<br>|
| resuscitated myocardial infarction<br>diagnostic analysis of platelet function of the patient cohort included according to the inclusion criteria | Other: diagnostic analysis of platelet function<br>* analysis of platelet aggregation using optical measurements as well as the commercial VerifyNow technique<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Platelet Inhibition Measured With Optical Aggregometry | Median (Inter-Quartile Range) Collagen AUC values on Day 3 measured with optical aggregometry The more light signal is detected, the better thrombocyte function is. | day 3 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants With Cumulative Clinical Endpoint of Death and Stent Thrombosis |  | 7 days |