Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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Recruitment Status
COMPLETED
Clinical Phase
PHASE4
Total Enrollment
64 participants
Study Classification
INTERVENTIONAL
Study Start Date
2015-03-31
Study Completion Date
2016-12-31
Brief Summary
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The purpose of this study is to determine the proportion of untreated donor platelets required to fully reverse the platelet inhibitory effects of ticagrelor and aspirin in healthy persons and patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) and receiving ticagrelor.
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Detailed Description
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Reversal of the Anti-platelet Effects of Ticagrelor: REVERSAL study
The fatality of stent thrombosis (ST) in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) is approximately 50% and clopidogrel is an important anti-platelet drug for prevention of ST. CAD patients implanted with stent including bare metal stent (BMS) and drug eluting stent (DES) are recommended to receive dual anti-platelet treatment (DAPT), i.e. clopidogrel along with aspirin, for at least one year to reduce the incidence of ST by up-to-date guidelines. However, due to the variability of anti-platelet effect of clopidogrel, regular dose (75 mg daily) of clopidogrel administered cannot achieve enough inhibition of platelet aggregation in 20-30% of total patients, which is named as clopidogrel low responsiveness (CLR), and the morbidity of thrombosis (including) in CAD patients is still 10%.
Ticagrelor, a cyclopentyl-triazolo-pyrimidine, is a more potent adenosine diphosphate (ADP) receptor antagonist with faster onset and more significantly higher inhibition of platelet aggregation compared with clopidogrel and directly acts on P2Y12-ADP receptor in platelets without process of hepatic metabolism. In the PLATO study, ticagrelor plus reduced the remarkable incidence of cardiovascular events in patients with acute coronary syndrome (ACS) without significant higher incidence of major bleeding events compared with clopidogrel plus aspirin. Surprisingly, the incidence of death due to cardiovascular causes and the total fatality was decreased in patients with ticagrelor plus aspirin compared with those with clopidogrel plus aspirin. The results suggested the more benefit brought by ticagrelor, highlighting the wide use of it in the future.
Due to the potent anti-platelet effect of ticagrelor, more bleeding events may occur. Additionally, when facing the need for cardiac or non-cardiac operation, occurrence of life-threatening bleeding event or necessity of emergency operation, doctors may be confused of the treatment for the patients taking ticagrelor, of which the half-life period is 8-9 hours and it suggests the importance of studying the reversal of the anti-platelet effects of ticagrelor.
The primary objective of this study is to investigate the proportion of untreated donor platelets required to fully reverse the platelet inhibitory effects of aspirin and ticagrelor in healthy persons and patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) and receiving ticagrelor.
Study Population:
The investigators design two cohort studies, and plan to enroll 32 healthy volunteers in cohort 1 and 16 patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) and receiving dual anti-platelet therapy (ticagrelor 90mg bid + aspirin 100mg daily) for 7 days
Cohort 1:
Randomization:
A total of 32 healthy volunteers are planned to be enrolled and will be randomly divided into three groups: single anti-platelet treatment group (A group, 8 of 32), dual anti-platelet treatment group (B group, 8 of 32) and control group (C group, 16 of 32).
1. Single anti-platelet treatment group: (Ticagrelor 90mg bid) × 7 days
2. Dual anti-platelet treatment group: (Ticagrelor 90mg bid + Aspirin 100mg daily) × 7 days
3. Control group: No anti-platelet therapy
Inclusion criteria:
1. Healthy volunteers
2. Participants aged \>18 years old
Exclusion criteria:
1. Allergy or intolerance to aspirin or ticagrelor;
2. Subjects at a high risk of bleeding (e.g. platelet count\<100×10\^9/L, history of peptic ulcer, hemoglobin\<110g/L);
3. Subjects with bronchial asthma or chronic obstructive pulmonary disease;
4. Subjects with bradycardia (e.g. sick sinus syndrome, high-grade atrioventricular block, history of syncope with unproved uncorrelation with bradycardia);
5. Smokers;
6. Subjects with diabetes mellitus;
7. Subjects planning to be pregnancy;
8. Subjects with hepatic or renal dysfunction;
9. Subjects who have taken other anti-platelet drugs, non-steroidal anti-inflammatory drugs or proton pump inhibitors before scanning or need to take them during study period.
Blood collection and sample preparation
Venous blood samples are collected by venipuncture into two 4.5-mL draw BD vacutainer tubes containing 0.105M buffered sodium citrate (3.2%) at 08.00 hours in the morning before taking the agent and after the last dose of the study drug. Platelet-rich plasma (PRP) from subjects in A group is mixed with increasing proportions of that in C group, with one untreated subject serving as the control for one treated subject. The proportion of control platelets mixed with inhibited platelets is calculated based on platelet numbers, starting at 10% and increasing by 10% increments. So as the PRP in B group.
Test:
1. Before taking the agent:
1. ADP-induced platelet aggregation: light transmittance aggregation (LTA) in response to 5μM ADP
2. Arachidonic acid (AA)-induced platelet aggregation: LTA in response to 1mM AA
2. After 7-day medication:
1. ADP-induced platelet aggregation: LTA in response to 5μM ADP
2. AA-induced platelet aggregation: LTA in response to 1mM AA
3. ADP-induced platelet aggregation of mixed sample: LTA in response to 5μM ADP
4. AA-induced platelet aggregation of mixed sample: LTA in response to 1mM AA
Primary end points:
1\. Reversal of the platelet inhibitory effects of antiplatelet therapy Proportion of untreated donor platelets required to fully reverse the platelet inhibitory effects of antiplatelet therapy in healthy volunteers
Secondary end points:
1\. Inhibition of platelet aggregation (IPA) in response to 5μM ADP determined by light transmittance aggregometer (LTA) after 7-day ticagrelor administration
Safety issue: No
Cohort 2:
A total of 16 patients with diagnosed coronary artery disease who have undergone percutaneous coronary intervention (PCI) and have received dual anti-platelet therapy (ticagrelor 90mg bid + aspirin 100mg daily) for 7 days is planned to be enrolled.
Inclusion Criteria:
1. Subjects with diagnosed coronary artery disease undergoing percutaneous coronary intervention (PCI);
2. Subjects who have received dual anti-platelet therapy (ticagrelor 90mg bid + aspirin 100mg daily) for 7 days;
Exclusion Criteria:
1. Subjects at a high risk of bleeding (e.g. platelet count\<100×10\^9/L, history of peptic ulcer, hemoglobin\<110g/L);
2. Subjects with anemia;
3. Smokers
4. Subjects planning to be pregnancy;
5. Subjects with hepatic or renal dysfunction;
6. Subjects who have taken other anti-platelet drugs, non-steroidal anti-inflammatory drugs or proton pump inhibitors before scanning or need to take them during study period.
Sample test for fresh platelet saved in blood bank
Function of platelet aggregation, platelet count, pH value and metabolic products (including PO2, PCO2, blood glucose, lactate, bicarbonate, sodium, potassium and chloride) are measured in fresh platelet sample preserved in blood bank for 1, 2, 3, 4, and 5 days respectively.
Blood collection and sample preparation for patients
Venous blood samples are collected by venipuncture into two 4.5-mL draw BD vacutainer tubes containing 0.105M buffered sodium citrate (3.2%) at 08.00 hours in the morning after taking the medicine. Platelet-rich plasma (PRP) from participants is mixed with increasing proportions of that extracted from fresh platelet sample reserved in blood bank for one day as the control for each treated subject. The proportion of control platelets mixed with inhibited platelets is calculated based on platelet numbers, starting at 10% and increasing by 10% increments. So as the PRP mixed with fresh platelet sample preserved for four days.
Test for sample from patients
1. Before mixture:
1. ADP-induced platelet aggregation: light transmittance aggregation (LTA) in response to 5μM ADP
2. Arachidonic acid (AA)-induced platelet aggregation: LTA in response to 1mM AA
2. After mixture:
1. ADP-induced platelet aggregation: LTA in response to 5μM ADP
2. AA-induced platelet aggregation: LTA in response to 1mM AA
Primary end points:
1\. Reversal of the platelet inhibitory effects of antiplatelet therapy Proportion of untreated donor platelets required to fully reverse the platelet inhibitory effects of antiplatelet therapy in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) and receiving ticagrelor
Secondary end points:
1\. Relationship between function of platelet aggregation and the time of saving fresh platelet.
Safety issue: No
The fatality of stent thrombosis (ST) in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) is approximately 50% and clopidogrel is an important anti-platelet drug for prevention of ST. CAD patients implanted with stent including bare metal stent (BMS) and drug eluting stent (DES) are recommended to receive dual anti-platelet treatment (DAPT), i.e. clopidogrel along with aspirin, for at least one year to reduce the incidence of ST by up-to-date guidelines. However, due to the variability of anti-platelet effect of clopidogrel, regular dose (75 mg daily) of clopidogrel administered cannot achieve enough inhibition of platelet aggregation in 20-30% of total patients, which is named as clopidogrel low responsiveness (CLR), and the morbidity of thrombosis (including) in CAD patients is still 10%.
Ticagrelor, a cyclopentyl-triazolo-pyrimidine, is a more potent adenosine diphosphate (ADP) receptor antagonist with faster onset and more significantly higher inhibition of platelet aggregation compared with clopidogrel and directly acts on P2Y12-ADP receptor in platelets without process of hepatic metabolism. In the PLATO study, ticagrelor plus reduced the remarkable incidence of cardiovascular events in patients with acute coronary syndrome (ACS) without significant higher incidence of major bleeding events compared with clopidogrel plus aspirin. Surprisingly, the incidence of death due to cardiovascular causes and the total fatality was decreased in patients with ticagrelor plus aspirin compared with those with clopidogrel plus aspirin. The results suggested the more benefit brought by ticagrelor, highlighting the wide use of it in the future.
Due to the potent anti-platelet effect of ticagrelor, more bleeding events may occur. Additionally, when facing the need for cardiac or non-cardiac operation, occurrence of life-threatening bleeding event or necessity of emergency operation, doctors may be confused of the treatment for the patients taking ticagrelor, of which the half-life period is 8-9 hours and it suggests the importance of studying the reversal of the anti-platelet effects of ticagrelor.
The primary objective of this study is to investigate the proportion of untreated donor platelets required to fully reverse the platelet inhibitory effects of aspirin and ticagrelor in healthy persons and patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) and receiving ticagrelor.
Study Population:
The investigators design two cohort studies, and plan to enroll 32 healthy volunteers in cohort 1 and 16 patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) and receiving dual anti-platelet therapy (ticagrelor 90mg bid + aspirin 100mg daily) for 7 days
Cohort 1:
Randomization:
A total of 32 healthy volunteers are planned to be enrolled and will be randomly divided into three groups: single anti-platelet treatment group (A group, 8 of 32), dual anti-platelet treatment group (B group, 8 of 32) and control group (C group, 16 of 32).
1. Single anti-platelet treatment group: (Ticagrelor 90mg bid) × 7 days
2. Dual anti-platelet treatment group: (Ticagrelor 90mg bid + Aspirin 100mg daily) × 7 days
3. Control group: No anti-platelet therapy
Inclusion criteria:
1. Healthy volunteers
2. Participants aged \>18 years old
Exclusion criteria:
1. Allergy or intolerance to aspirin or ticagrelor;
2. Subjects at a high risk of bleeding (e.g. platelet count\<100×10\^9/L, history of peptic ulcer, hemoglobin\<110g/L);
3. Subjects with bronchial asthma or chronic obstructive pulmonary disease;
4. Subjects with bradycardia (e.g. sick sinus syndrome, high-grade atrioventricular block, history of syncope with unproved uncorrelation with bradycardia);
5. Smokers;
6. Subjects with diabetes mellitus;
7. Subjects planning to be pregnancy;
8. Subjects with hepatic or renal dysfunction;
9. Subjects who have taken other anti-platelet drugs, non-steroidal anti-inflammatory drugs or proton pump inhibitors before scanning or need to take them during study period.
Blood collection and sample preparation
Venous blood samples are collected by venipuncture into two 4.5-mL draw BD vacutainer tubes containing 0.105M buffered sodium citrate (3.2%) at 08.00 hours in the morning before taking the agent and after the last dose of the study drug. Platelet-rich plasma (PRP) from subjects in A group is mixed with increasing proportions of that in C group, with one untreated subject serving as the control for one treated subject. The proportion of control platelets mixed with inhibited platelets is calculated based on platelet numbers, starting at 10% and increasing by 10% increments. So as the PRP in B group.
Test:
1. Before taking the agent:
1. ADP-induced platelet aggregation: light transmittance aggregation (LTA) in response to 5μM ADP
2. Arachidonic acid (AA)-induced platelet aggregation: LTA in response to 1mM AA
2. After 7-day medication:
1. ADP-induced platelet aggregation: LTA in response to 5μM ADP
2. AA-induced platelet aggregation: LTA in response to 1mM AA
3. ADP-induced platelet aggregation of mixed sample: LTA in response to 5μM ADP
4. AA-induced platelet aggregation of mixed sample: LTA in response to 1mM AA
Primary end points:
1\. Reversal of the platelet inhibitory effects of antiplatelet therapy Proportion of untreated donor platelets required to fully reverse the platelet inhibitory effects of antiplatelet therapy in healthy volunteers
Secondary end points:
1\. Inhibition of platelet aggregation (IPA) in response to 5μM ADP determined by light transmittance aggregometer (LTA) after 7-day ticagrelor administration
Safety issue: No
Cohort 2:
A total of 16 patients with diagnosed coronary artery disease who have undergone percutaneous coronary intervention (PCI) and have received dual anti-platelet therapy (ticagrelor 90mg bid + aspirin 100mg daily) for 7 days is planned to be enrolled.
Inclusion Criteria:
1. Subjects with diagnosed coronary artery disease undergoing percutaneous coronary intervention (PCI);
2. Subjects who have received dual anti-platelet therapy (ticagrelor 90mg bid + aspirin 100mg daily) for 7 days;
Exclusion Criteria:
1. Subjects at a high risk of bleeding (e.g. platelet count\<100×10\^9/L, history of peptic ulcer, hemoglobin\<110g/L);
2. Subjects with anemia;
3. Smokers
4. Subjects planning to be pregnancy;
5. Subjects with hepatic or renal dysfunction;
6. Subjects who have taken other anti-platelet drugs, non-steroidal anti-inflammatory drugs or proton pump inhibitors before scanning or need to take them during study period.
Sample test for fresh platelet saved in blood bank
Function of platelet aggregation, platelet count, pH value and metabolic products (including PO2, PCO2, blood glucose, lactate, bicarbonate, sodium, potassium and chloride) are measured in fresh platelet sample preserved in blood bank for 1, 2, 3, 4, and 5 days respectively.
Blood collection and sample preparation for patients
Venous blood samples are collected by venipuncture into two 4.5-mL draw BD vacutainer tubes containing 0.105M buffered sodium citrate (3.2%) at 08.00 hours in the morning after taking the medicine. Platelet-rich plasma (PRP) from participants is mixed with increasing proportions of that extracted from fresh platelet sample reserved in blood bank for one day as the control for each treated subject. The proportion of control platelets mixed with inhibited platelets is calculated based on platelet numbers, starting at 10% and increasing by 10% increments. So as the PRP mixed with fresh platelet sample preserved for four days.
Test for sample from patients
1. Before mixture:
1. ADP-induced platelet aggregation: light transmittance aggregation (LTA) in response to 5μM ADP
2. Arachidonic acid (AA)-induced platelet aggregation: LTA in response to 1mM AA
2. After mixture:
1. ADP-induced platelet aggregation: LTA in response to 5μM ADP
2. AA-induced platelet aggregation: LTA in response to 1mM AA
Primary end points:
1\. Reversal of the platelet inhibitory effects of antiplatelet therapy Proportion of untreated donor platelets required to fully reverse the platelet inhibitory effects of antiplatelet therapy in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) and receiving ticagrelor
Secondary end points:
1\. Relationship between function of platelet aggregation and the time of saving fresh platelet.
Safety issue: No
Conditions
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Coronary Artery Disease
Study Design
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Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
Primary Study Purpose
TREATMENT
Blinding Strategy
SINGLE
Investigators
Study Groups
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Single Anti-platelet Treatment
Ticagrelor
Group Type
EXPERIMENTAL
Ticagrelor
Intervention Type
DRUG
(Ticagrelor 90mg Bid) x 7days
Dual Anti-platelet Treatment
Aspirin + Ticagrelor
Group Type
EXPERIMENTAL
Aspirin + Ticagrelor
Intervention Type
DRUG
(Aspirin 100mg daily + Ticagrelor 90mg Bid) x 7days
Control
No Drug
Group Type
SHAM_COMPARATOR
Control
Intervention Type
DRUG
No Anti-platelet Therapy
CAD undergoing PCI
Patients with coronary artery disease undergoing percutaneous coronary intervention and receiving dual anti-platelet therapy (ticagrelor 90mg bid + aspirin 100mg daily)
Group Type
OTHER
Aspirin + Ticagrelor
Intervention Type
DRUG
Dual anti-platelet therapy (Aspirin 100mg daily + Ticagrelor 90mg Bid) after percutaneous coronary intervention (PCI)
Interventions
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Ticagrelor
(Ticagrelor 90mg Bid) x 7days
Intervention Type
DRUG
Aspirin + Ticagrelor
(Aspirin 100mg daily + Ticagrelor 90mg Bid) x 7days
Intervention Type
DRUG
Control
No Anti-platelet Therapy
Intervention Type
DRUG
Aspirin + Ticagrelor
Dual anti-platelet therapy (Aspirin 100mg daily + Ticagrelor 90mg Bid) after percutaneous coronary intervention (PCI)
Intervention Type
DRUG
Other Intervention Names
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Brilinta
Brilinta
Brilinta
Eligibility Criteria
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Inclusion Criteria
* Healthy volunteers;
* Subjects aged \>18 years old;
* Subjects with diagnosed coronary artery disease undergoing percutaneous coronary intervention (PCI);
* Subjects who have received dual anti-platelet therapy (ticagrelor 90mg bid + aspirin 100mg daily) for 7 days;
* Subjects aged \>18 years old;
* Subjects with diagnosed coronary artery disease undergoing percutaneous coronary intervention (PCI);
* Subjects who have received dual anti-platelet therapy (ticagrelor 90mg bid + aspirin 100mg daily) for 7 days;
Exclusion Criteria
* Allergy or intolerance to aspirin or ticagrelor;
* Subjects at a high risk of bleeding (e.g. platelet count\<100×10\^9/L, history of peptic ulcer, hemoglobin\<110g/L);
* Subjects with anemia;
* Subjects with bronchial asthma or chronic obstructive pulmonary disease;
* Subjects with bradycardia (e.g. sick sinus syndrome, high-grade atrioventricular block, history of syncope with unproved uncorrelation with bradycardia);
* Smokers;
* Subjects with diabetes mellitus;
* Subjects planning to be pregnancy;
* Subjects with hepatic or renal dysfunction;
* Subjects who have taken other anti-platelet drugs, non-steroidal anti-inflammatory drugs or proton pump inhibitors before scanning or need to take them during study period.
Cohort 2:
* Subjects at a high risk of bleeding (e.g. platelet count\<100×10\^9/L, history of peptic ulcer, hemoglobin\<110g/L);
* Subjects with anemia;
* Smokers
* Subjects planning to be pregnancy;
* Subjects with hepatic or renal dysfunction;
* Subjects who have taken other anti-platelet drugs, non-steroidal anti-inflammatory drugs or proton pump inhibitors before scanning or need to take them during study period.
* Subjects at a high risk of bleeding (e.g. platelet count\<100×10\^9/L, history of peptic ulcer, hemoglobin\<110g/L);
* Subjects with anemia;
* Subjects with bronchial asthma or chronic obstructive pulmonary disease;
* Subjects with bradycardia (e.g. sick sinus syndrome, high-grade atrioventricular block, history of syncope with unproved uncorrelation with bradycardia);
* Smokers;
* Subjects with diabetes mellitus;
* Subjects planning to be pregnancy;
* Subjects with hepatic or renal dysfunction;
* Subjects who have taken other anti-platelet drugs, non-steroidal anti-inflammatory drugs or proton pump inhibitors before scanning or need to take them during study period.
Cohort 2:
* Subjects at a high risk of bleeding (e.g. platelet count\<100×10\^9/L, history of peptic ulcer, hemoglobin\<110g/L);
* Subjects with anemia;
* Smokers
* Subjects planning to be pregnancy;
* Subjects with hepatic or renal dysfunction;
* Subjects who have taken other anti-platelet drugs, non-steroidal anti-inflammatory drugs or proton pump inhibitors before scanning or need to take them during study period.
Minimum Eligible Age
18 Years
Maximum Eligible Age
80 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
Yes
Sponsors
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National Natural Science Foundation of China
OTHER_GOV
Sponsor Role
collaborator
The First Affiliated Hospital with Nanjing Medical University
OTHER
Sponsor Role
lead
Responsible Party
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Chunjian Li
Professor
Responsibility Role
PRINCIPAL_INVESTIGATOR
Principal Investigators
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Chunjian Li, Ph.D
Role: PRINCIPAL_INVESTIGATOR
The First Affiliated Hospital with Nanjing Medical University
Locations
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First Affiliated Hospital of Nanjing Medical University
Nanjing, Jiangsu, China
Site Status
Countries
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China
References
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Mehta SR, Yusuf S, Peters RJ, Bertrand ME, Lewis BS, Natarajan MK, Malmberg K, Rupprecht H, Zhao F, Chrolavicius S, Copland I, Fox KA; Clopidogrel in Unstable angina to prevent Recurrent Events trial (CURE) Investigators. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet. 2001 Aug 18;358(9281):527-33. doi: 10.1016/s0140-6736(01)05701-4.
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Kushner FG, Hand M, Smith SC Jr, King SB 3rd, Anderson JL, Antman EM, Bailey SR, Bates ER, Blankenship JC, Casey DE Jr, Green LA, Hochman JS, Jacobs AK, Krumholz HM, Morrison DA, Ornato JP, Pearle DL, Peterson ED, Sloan MA, Whitlow PL, Williams DO. 2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update) a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2009 Dec 1;54(23):2205-41. doi: 10.1016/j.jacc.2009.10.015. No abstract available.
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Chong AY, So DY. Ticagrelor for the treatment of peripheral arterial disease. Expert Opin Investig Drugs. 2014 Dec;23(12):1737-43. doi: 10.1517/13543784.2014.974803. Epub 2014 Nov 6.
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Li C, Hirsh J, Sloane D, Liang Y, Bai J, Paikin J, Johnston MA, DeBeer J, Eikelboom JW. Aspirin response variability after major orthopedic surgery. Thromb Res. 2012 Aug;130(2):216-20. doi: 10.1016/j.thromres.2012.04.006. Epub 2012 May 9.
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Teng R, Butler K. Pharmacokinetics, pharmacodynamics, tolerability and safety of single ascending doses of ticagrelor, a reversibly binding oral P2Y(12) receptor antagonist, in healthy subjects. Eur J Clin Pharmacol. 2010 May;66(5):487-96. doi: 10.1007/s00228-009-0778-5. Epub 2010 Jan 21.
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Li C, Hirsh J, Xie C, Johnston MA, Eikelboom JW. Reversal of the anti-platelet effects of aspirin and clopidogrel. J Thromb Haemost. 2012 Apr;10(4):521-8. doi: 10.1111/j.1538-7836.2012.04641.x.
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Storey RF, Bliden KP, Ecob R, Karunakaran A, Butler K, Wei C, Tantry U, Gurbel PA. Earlier recovery of platelet function after discontinuation of treatment with ticagrelor compared with clopidogrel in patients with high antiplatelet responses. J Thromb Haemost. 2011 Sep;9(9):1730-7. doi: 10.1111/j.1538-7836.2011.04419.x.
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Coelho MJ, Monteiro Tde C, Vasquez FG, Silva KL, Dos Santos KS, de Oliveira VM, Cavalcante Fde O. Platelet aggregation and quality control of platelet concentrates produced in the Amazon Blood Bank. Rev Bras Hematol Hemoter. 2011;33(2):110-4. doi: 10.5581/1516-8484.20110030.
Reference Type
BACKGROUND
Shams Hakimi C, Hesse C, Wallen H, Boulund F, Grahn A, Jeppsson A. In vitro assessment of platelet concentrates with multiple electrode aggregometry. Platelets. 2015;26(2):132-7. doi: 10.3109/09537104.2014.898141. Epub 2014 Jul 7.
Reference Type
BACKGROUND
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
003
Identifier Type: -
Identifier Source: org_study_id
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