Monitoring Antiplatelet Drugs in Cardiac Arrest Patients (PLT-ECMO)

University of Milano Bicocca

Status: Enrolling

Conditions: Myocardial Infarction; Platelet Dysfunction; Extracorporeal Membrane Oxygenation; Cardiac Arrest

Treatments: Drug: Antiplatelet Drug

Study type: Observational

Funder types: Other

Identifiers

NCT05730114

3940

Details and patient eligibility

About

Dual Antiplatelet Therapy (DAPT) with acetylsalicylic acid (ASA) and oral P2Y12 inhibitor (Clopidogrel, Ticagrelor or Prasugrel) is recommended in STEMI or NSTEMI patients undergoing primary Percutaneous Coronary Intervention (PCI). There is evidence for an increased risk of stent thrombosis after PCI despite administration of DAPT in patients resuscitated from a cardiac arrest with STEMI/NSTEMI who undergo primary PCI, in particular for those treated with hypothermia. Point of Care Aggregometry represents an emerging tool to measure platelet reactivity in patient treated with antiplatelets drugs. Among patients with Acute Coronary Syndrome (ACS), those requiring Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) for refractory Cardiogenic Shock or Cardiac Arrest represent a growing population burdened by more profound metabolic, pharmacokinetic, hemostatic and physiological alterations due to increased clinical severity and ECMO itself. In addition, profound platelet inhibition can result in a higher risk of bleeding complication, since these patients have to be simultaneously anticoagulated with unfractioned heparin (UFH) and ECMO itself can cause coagulopathy. We aimed to perform an observational prospective cohort study to investigate platelet reactivity in a population of ACS patients with different clinical severity.

Enrollment: 60 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients P2Y12 naive
• Suffering from Acute Coronary Syndrome needing primary percutaneous coronary intervention (PCI) and treated with oral antiP2Y12 drugs

Exclusion criteria

• Known liver or hematological disease
• Anticoagulant therapy
• Active bleeding needing blood transfusions.

Trial design

60 participants in 3 patient groups

OHCA/ECMO

Description:

Patient resuscitated from Out of Hospital Cardiac Arrest from acute coronary syndrome and on VA-ECMO.

Treatment:

Drug: Antiplatelet Drug

OHCA/nonECMO

Description:

Patient resuscitated from Out of Hospital Cardiac Arrest from acute coronary syndrome and without VA-ECMO.

Treatment:

Drug: Antiplatelet Drug

nonOHCA/nonECMO

Description:

Patient with acute coronary syndrome without Out of Hospital Cardiac Arrest from acute coronary syndrome and without VA-ECMO.

Treatment:

Drug: Antiplatelet Drug