Abstract 15727: Platelet Inhibition With Ticagrelor and Clopidogrel in Comatose Survivors of Out-of-Hospital Cardiac Arrest

Comatose survivors of out-of-hospital cardiac arrest (OHCA) nowadays frequently undergo immediate percutaneous coronary intervention (PCI) which is associated with the need for antiplatelet therapy with P2Y12 inhibitors. In the present study we investigated platelet inhibition in 19 comatose survivors of OHCA undergoing PCI and hypothermia (32-34 oC) who were randomized to clopidogrel 600 mg loading followed by 75 mg/day (n=6) or ticagrelor 180 mg loading followed by 90mg bid (n=13) administered as crushed and dissolved tablets via nasogastric tube. Platelet inhibition was measured by VerifyNow® and Multiplate® aggregometry at baseline, and 2, 4, 12, 22 and 48 hours after loading dose. VerifyNow® revealed greater platelet inhibition with ticagrelor becoming statistically significant 12 hours after the loading (Figure). Also Multiplate ADPtest revealed greater platelet inhibition after ticagrelor at 4 hours (21.5±13.9 vs. 38.7±16.8, p=0.03), 12 hours (15.4±12.0 vs. 36.3±8.7, pu003c0.01) and 22 hours (14.3±6.1 vs. 26.3±4.3, pu003c0.01). Accordingly, our preliminary results indicate that ticagrelor has faster and stronger antiplatelet effect than clopidogrel during the initial 48 hours of postresuscitation phase and maybe a P2Y12 of choice in comatose survivors of OHCA undergoing PCI. ![][1] [1]: /embed/graphic-1.gif