Ticagrelor effectively inhibits platelet aggregation in comatose survivors of cardiac arrest undergoing primary percutaneous coronary intervention treated with mild therapeutic hypothermia

Figures

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  Figure 1. Data are presented as peak platelet reactivity units (PRUs) in the primary percutaneous coronary intervention-mild therapeutic hypothermia (PCI-MTH) group (black bars) and the control group (blue bars) at baseline, during hypothermia at T1 (12–24 h), and after the rewarming phase at T2 (48–72 h) after the ticagrelor loading dose. Thresholds at 194 PRU indicate high on-treatment reactivity. Mean ± standard deviation is shown. The statistical power calculations used at each time point are as follows: baseline: statistical power: 0.21 (Mi1 = 264.9; Mi2 = 246.1; δ = 44.9; α = 0.05), T1 — statistical power: 0.51 (Mi1 = 86.7; Mi2 = 31.1; δ = 75.63; α = 0.05), T2 — statistical power: 0.27 (Mi1 = = 63.6; Mi2 = 41.3; δ = 44.7; α = 0.05); p < 0.05; ADP — adenosine diphosphate.

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  Figure 2. VerifyNow platelet reactivity in P2Y12 assay (Accumetrics, Inc., San Diego, CA, USA). Data show a comparison of the antiplatelet effect between the primary percutaneous coronary intervention-mild therapeutic hypothermia (PCI-MTH) group (black bars) and the control group (blue bars) at baseline, T1 (12–24 h), and T2 (48–72 h) after a loading dose of ticagrelor. Platelet reactivity is expressed as the percentage of platelet inhibition. Mean ± standard deviation is shown, p < 0.05. The statistical power calculations used at each time point are as follows: baseline: statistical power: 0.05 (Mi1 = 0.22; Mi2 = 0.35; δ = 1.13; α = 0.05), T1 — statistical power: 0.48 (Mi1 = 67.4; Mi2 = 86.4; δ = 26.9; α = 0.05), T2 — statistical power: 0.25 (Mi1 = 74.7; Mi2 = 82.6; δ = 16.6; α = 0.05); p < 0.05; ADP — adenosine diphosphate.

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  Figure 3. A. Platelet reactivity by treatment. VerifyNow P2Y12 assay results: Individual results for the VerifyNow P2Y12 assay (Accumetrics, Inc., San Diego, CA, USA) are expressed as P2Y12 reaction units (platelet reactivity units [PRU]) at baseline (0 h) and each measured time point: T1 (12–24 h) and T2 (48–72 h) after ticagrelor loading dose. Platelet inhibition with 90 mg ticagrelor twice daily in n = 18 primary percutaneous coronary intervention-mild therapeutic hypothermia (PCI-MTH) patients (empty blue squares) is shown in comparison to n = 14 normothermic patients after primary PCI in the control group (red dots). Solid lines with error bars indicate the least-square means (95% confidence interval). The dashed line indicates a level of 194 PRU as a threshold for high platelet reactivity. There is no significant difference between the groups (all p > 0.01); ADP — adenosine diphosphate; B. Inhibition of platelet aggregation by VerifyNow P2Y12 assay (Accumetrics, Inc., San Diego, CA, USA) at baseline (0 h), T1 (12–24 h), and T2 (48–72 h) after ticagrelor loading and maintenance therapy in n = 18 primary percutaneous coronary intervention-mild therapeutic hypothermia (PCI-MTH) patients…