Platelet Function in Resuscitated Patients-2

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, secured inhibition and knowledge of the individual platelet function is valuable.

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 using cangrelor as P2Y12 (purinergic G protein-coupled receptors-12) inhibitor plus acetylsalicylic acid (ASS). Patients are treated with therapeutic hypothermia according to the local Standard operating procedure for 24h and rewarming is performed within an additional 5 to 20h. Platelet function is measured every morning and ASS mediated as well as P2Y12 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 (4 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-2

Conditions
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Acute Myocardial Infarction, Cardiac Arrest

Intervention / Treatment
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* Diagnostic Test: diagnostic test 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 |
| --- | --- |
| oral P2Y12 inhibition<br>Patients with cardiac arrest and myocardial infarction treated with oral P2Y12 Inhibitor (from the historic cohort of NCT02914795) | Diagnostic Test: diagnostic test of platelet function<br>* Light transmittance aggregometry and VerifyNow<br>|
| intravenous P2Y12 inhibition<br>Patients with cardiac arrest and myocardial infarction treated with intravenous P2Y12 Inhibitor (cangrelor) | Diagnostic Test: diagnostic test of platelet function<br>* Light transmittance aggregometry and VerifyNow<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 | Light transmittance aggregometry | 4 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Composite of death and stent thrombosis | Composite of death and stent thrombosis | 4 days |