Celia Garilleti Cámara, José María de la Torre-Hernández, José Ramón Rumoroso Cuevas, Sebastián Romaní, Andrea Virginia Monastyrski, Alejandro Diego Nieto, Jeremías Bayón Lorenzo, Héctor Cubero Gallego, Joan Antoni Gómez-Hospital, Nuria Vallejo Calcerrada, Ainhoa Pérez Guerrero, Ignacio J Amat-Santos, Vicente Alcalde Martínez, Ramón López-Palop, Javier Jimeno Sánchez, Armando Pérez de Prado, Íñigo Lozano Martínez-Luengas
This study will determine whether platelet function testing provide clinical benefit in the management of patients with ACS.
INTRODUCTION AND OBJECTIVES: De-escalation from prasugrel and ticagrelor to clopidogrel in patients undergoing percutaneous coronary intervention after acute coronary syndrome (ACS) is a strategy aimed at reducing bleeding. This study evaluates whether VerifyNow (Werfen, Spain)-guided de-escalation, based on platelet aggregation measurement, provides a therapeutic benefit in ACS management.
METHODS: This ongoing multicenter, prospective, randomized 1:1 trial will enroll 634 patients with ACS who underwent revascularization with a sirolimus-eluting stent and were discharged on dual antiplatelet therapy with ticagrelor or prasugrel. Only those patients with a very low platelet reactivity level (platelet reactivity units ≤ 30) based on VerifyNow 1 month after discharge will be included. The primary endpoint is a composite of cardiovascular death, nonfatal acute myocardial infarction, nonfatal stroke, and bleeding at 1-year follow-up.
RESULTS: The EPIC17-VERONICA study (NCT04654052) will reveal the efficacy profile of the de-escalation strategy, based on the VerifyNow platelet aggregation test, and determine the role of this device in the selection of patients who are eligible to benefit from this strategy.
CONCLUSIONS: This study will determine whether platelet function testing provide clinical benefit in the management of patients with ACS.