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Prognostic Implications of Dual Platelet Reactivity Testing in Acute Coronary Syndrome

Despite advances in treatment, patients with acute coronary syndrome (ACS) continue to be exposed to both short- and long-term thrombotic events. Even with early invasive management, up to 10% of patients hospitalized for ACS will have a recurrent ischaemic event within 12 months of the index hospitalization. Dual-antiplatelet therapy (DAPT) with aspirin and an adenosine diphosphate receptor (ADP) antagonist (clopidogrel, prasugrel, or ticagrelor) is the cornerstone treatment to prevent intraprocedural thrombotic events and postdischarge ischaemic events in patients with ACS. On-treatment platelet reactivity (PR) testing, which measures in vitro platelet aggregation following treatment with antiplatelet therapy, has been proposed as a means of predicting the risk of thrombotic events in patients treatedwith antiplatelet therapy. We hypothesized that pre- and post-procedural testing for HASPR (high on-ADP receptor antagonist platelet reactivity) and high on-ADP receptor antagonist platelet reactivity will predict IPTE, 30-day and 12-month MACCE, respectively, in patients with ACS on DAPT.