The Relationship of Platelet Micro-RNA Expression and Platelet Reactivity in Patients Under Clopidogrel or Ticagrelor Treatment

Study Overview
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Brief Summary
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For acute coronary syndrome patients undergoing cardiac catheterization after stenting, we will give dual antiplatelet drugs (dual antiplatelet agents) therapy, the choice of the basis of medical criteria (clinical guidelines) routine as aspirin + clopidogrel or aspirin + ticagrelor, according to medical guidelines currently no other disposal alternative proposal (unless adverse drug tolerance or bleeding can not be administered); idea of this experiment for acute coronary syndrome or conventional cardiac catheterization after stenting, platelet miRNA expression (miR-96 , miR-200b, miR-495, miR-107) after cardiac catheterization and interventional treatment of clopidogrel or ticagrelor acceptance of platelet reactivity (PRU) correlation values (given clopidogrel or ticagrelor determined by the clinician, the patient follow-up experiment to track only and observation), aims to explore under different platelet reactivity (hyper-reactive or hypo-reactive), their differences in miRNA performance.

Conditions
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PRU, miRNA

Intervention / Treatment
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* Procedure: miRNA within 24hr
* Procedure: miRNA after 1 week
* Procedure: miRNA after 1 month


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1 under DAPT (dual antiplatelet therapy) of stable angina patients for elective stent implantation. 2. DAPT 24 hours after treatment PRU (platelet activity units) values. (Drug unresponsive patients was defined as PRU> 235). Exclusion Criteria: 1.Not suitable for the treatment of patients with DAPT. (Active peptic ulceration or bleeding) 2 patients of aspirin, clopidogrel, ticagrelor, cilostazol medication intolerance. 3 contraindications for aspirin, clopidogrel, ticagrelor, cilostazol drug usage (such as heart failure patients not suitable for use cilostazol).

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 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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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: control<br>normal subjects. | Procedure: miRNA within 24hr<br>* miRNA within 24hr<br>Procedure: miRNA after 1 week<br>* miRNA after 1 week<br>Procedure: miRNA after 1 month<br>* miRNA after 1 month<br>|
| Active Comparator: clopidogrel<br>subjects received clopidogrel 75mg qd. | Procedure: miRNA within 24hr<br>* miRNA within 24hr<br>Procedure: miRNA after 1 week<br>* miRNA after 1 week<br>Procedure: miRNA after 1 month<br>* miRNA after 1 month<br>|
| Active Comparator: ticagrelor<br>subjects received ticagrelor 90mg qd. | Procedure: miRNA within 24hr<br>* miRNA within 24hr<br>Procedure: miRNA after 1 week<br>* miRNA after 1 week<br>Procedure: miRNA after 1 month<br>* miRNA after 1 month<br>|
| Active Comparator: cilostazol<br>subjects received cilostazol 100mg bid. | Procedure: miRNA within 24hr<br>* miRNA within 24hr<br>Procedure: miRNA after 1 week<br>* miRNA after 1 week<br>Procedure: miRNA after 1 month<br>* miRNA after 1 month<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| miRNA | miRNA-365-3p measure by Roche miRNA kits; PRP(platelet riched plasma) isolated miRNA by isolation Kit, then havest in cDNA synthesis Kit; then perform RT PCR. . | 7 days |