Acute Coronary Syndrome
Conditions
Keywords
ACS, Beta Blockers, platelet aggregation, light transmission aggregometry, Beta-Adrenergic Blockers
Brief summary
The Investigators will test the hypothesis that nonselective beta-blockers would have a more pronounced effect on platelet aggregation than selective beta-blockers in patients with acute coronary syndrome treated with dual anti platelet therapy.
Detailed description
In patients with acute coronary syndrome (ACS) beta-blockers are recommended for secondary prevention. It is known that catecholamine levels can potentiate platelet reactivity and beta-blocking agents may also affect platelet aggregation. This effect is mainly mediated by adrenergic receptors on platelets. This suggests that nonselective beta-blockers would have a more pronounced effect on platelet aggregation than selective beta-blockers. However, little is known about the effect of beta-blockers on platelet aggregation in patients with cardiovascular disease and, to date, nothing is known in the setting of ACS. The aim of the present study is to evaluate the effect of selective and nonselective beta-blockers on platelet aggregation in ACS patients treated with dual anti platelet therapy.
Interventions
DRUGCarvedilol
Patients randomized to this group will receive carvedilol at the highest dose tolerated
DRUGMetoprolol
Patients randomized to this group will receive metoprolol at the highest dose tolerated
Sponsors
Federico II University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* Acute Coronary Syndrome * Current dual anti platelet treatment with acetylsalicylic acid and Ticagrelor
Exclusion criteria
* ongoing prasugrel, ticlopidine or clopidogrel therapy * Creatinine Clearance \< 30 ml/min/1.73mm2 * Moderate to severe anemia Hemoglobin \< 10 mg/dl * Platelet count \>600000/mm3 or \<150000/mm3 or hematocrit \>50% or \<25% * concomitant neoplastic or immune-mediated pathologies * severe pulmonary pathologies * contraindication to beta blocker therapy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Platelet aggregation | 30 days | Platelet aggregation induced by epinephrine is measured by Light Transmission Aggregometry (LTA) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 30-days platelet aggregation | 30 days | Platelet aggregation induced by Adenosine Diphosphate (ADP) is measured by Light Transmission Aggregometry (LTA) |
| 30-days clinical events | 30 days | Major adverse cardiac events (MACE) and bleedings will be evaluated |
Countries
Italy
Outcome results
None listed