Send to

Choose Destination
See comment in PubMed Commons below
Thromb Res. 2013 Jul;132(1):e15-8. doi: 10.1016/j.thromres.2013.04.030. Epub 2013 May 30.

Platelet reactivity evaluated with the VASP assay following ticagrelor loading dose in acute coronary syndrome patients undergoing percutaneous coronary intervention.

Author information

Département de cardiologie, Hôpital universitaire nord, Aix-Marseille Univ., Marseille, France.



The level of platelet reactivity (PR) inhibition obtained after P2Y12-ADP receptor antagonist loading dose (LD) is associated with the ischemic and bleeding risk following percutaneous coronary intervention (PCI) in acute coronary syndromes (ACS).


We aimed to evaluate the level of PR inhibition achieved by a 180 mg LD of ticagrelor and the rate of high on-treatment platelet reactivity (HTPR) in ACS patients undergoing PCI.


We performed a multicentre prospective observational study enrolling ACS patients undergoing PCI. Patients were included if they were admitted for ST-elevation myocardial infarction or non ST-elevation ACS. To assess PR, a VASP index was measured at least 6 and within 24 hours following a 180 mg LD of ticagrelor. HTPR was defined as a VASP index ≥50%.


One hundred and fifteen patients were included: 31.3% of STEMI, 49.6% of NSTEMI and 19.1% of unstable angina. Following ticagrelor LD the mean VASP index was 17±14%. However the response to ticagrelor was not uniform with a small inter-individual variability: inter quartile range: 7.6-22.8% and a rate of HTPR of 3.5%. A high number of patients, 65.6%, had a VASP index <16%. None of the baseline characteristics of the study population was associated with PR. In addition, PR was similar in STEMI, NSTEMI and unstable angina (p=0.9).


In ACS patients the level of PR inhibition achieved by a 180 mg loading dose of ticagrelor is not uniform and the rate of HTPR is 3.5%. A high proportion of patients exhibited a VASP index <16%.


ACS; Acute coronary syndromes; HTPR; LD; LTPR; NSTEMI; On-treatment platelet reactivity; P2Y12-ADP receptor antagonist; PCI; PR; ST segment elevation myocardial infarction; STEMI; Ticagrelor; VASP; VASP index; Vasodilator-stimulated phosphoprotein; acute coronary syndrome; high on-treatment platelet reactivity; loading dose; low on-treatment platelet reactivity; non ST segment elevation myocardial infarction; percutaneous coronary intervention; platelet reactivity

[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center