Pharmacodynamic Evaluation of Antiplatelet Effect of Swallowing Versus Chewing Ticagrelor in Patients With Acute Coronary Syndrome

Inclusion Criteria:

• All patients presenting to the emergency department with acute coronary syndrome forpercutaneous coronary intervention

Exclusion Criteria:

• Age <18 years
• Known coagulopathy, bleeding diathesis, or active bleeding
• History of recent gastrointestinal or genitourinary bleeding within 2 months
• Previous therapy with clopidogrel, prasugrel, or ticagrelor
• Previous treatment with glycoprotein IIb/IIIa inhibitors or during interventionalprocedure
• Major surgery within 6 weeks
• History of intracranial bleeding or intracraneal neoplasm
• Suspected aortic dissection
• Chronic obstructive pulmonary disease
• Severe hemodynamic instability or cardiogenic shock
• Resuscitated cardiac arrest
• Use of vitamin K anticoagulants or novel oral anticoagulants (NOACs) within 7 days
• Life expectancy <1 year
• Known severe liver or renal disease, GFR estimated by CKD-EPI <30 ml/min/1.73 m2
• Known HIV treatment
• Hemoglobin <10 g/dL
• Platelet count <100,000/L
• Pregnancy
• Known allergy to ticagrelor
• Refusal to sign informed consent