萝莉社

You are being asked to participate in this study because you have a stent in your heart artery for at least 90 days and you are currently taking blood-thinning medications as part of your standard of care. In particular, you are taking two blood-thinning medications, which include baby aspirin plus either Prasugrel (Effient) or Ticagrelor (Brilinta). These blood-thinning medications prevent your blood cells, called platelets, from sticking together, which helps to prevent clots and heart attacks. While these medications are effective at preventing your stent from clotting and heart attacks, they also increase the risk of bleeding. To reduce the risk of bleeding while still protecting your heart, doctors sometimes use a strategy called “de-escalation” of blood thinning medication. One of the methods of de-escalation involves stopping aspirin after the first 90 days after your stent is placed and continuing to take your other blood thinner (Prasugrel or Ticagrelor). Research shows that de-escalation can lower the risk of bleeding without increasing the risk of stent clotting or heart attacks. However, there are no studies which compare the blood thinning effects of Prasugrel and Ticagrelor after stopping aspirin. Therefore, the purpose of this study is to see how Prasugrel or Ticagrelor without aspirin will work in your body.

Inclusion criteria:

1. Patients on DAPT with aspirin plus prasugrel 10 mg or ticagrelor 90 mg bid as per standard of care at least 90 days after PCI.
2. Age between 18 and 75 years old
3. Able to provide written informed consent

Exclusion criteria:

1. Prior history of stent thrombosis
2. PCI within 90 days.
3. History of stroke/TIA
4. Age > 75 years old
5. Weight < 60 kg
6. History of intracranial hemorrhage
7. On treatment with any oral anticoagulant or chronic low-molecular-weight heparin (at venous thrombosis treatment, not for prophylaxis)
8. Patients with known coagulation disorders
9. Known severe hepatic impairment
10. Hypersensitivity to prasugrel or ticagrelor
11. Pregnant and breastfeeding persons [persons of childbearing age must use reliable birth control (i.e., oral contraceptives) while participating in the study]. If the potential subject is a person of childbearing potential, a pregnancy test will be done. If the subject is pregnant, participation in this study will end.