Platelet Phenomic Analysis to guide patient stratification and anti-platelet medication in acute coronary syndrome

Anti-platelet drugs are used to reduce the risk of thrombosis, and while these show benefits in some patients, increased risk of bleeding means that they are no longer recommended for primary prevention. While such medication is effective for secondary prevention in many patients, others gain little protection from further cardiovascular events. A one-size-fits-all approach is used where patients who may benefit or be harmed are not identified. In this study, we will determine the ability of Platelet Phenomics Analysis (PPA) to identify patients with acute coronary syndrome who have high or low platelet reactivity, and together with pharmacogenomics (PGx) analysis assess the impact of anti-platelet therapy on their PPA profile. In a second cohort of patients, we will perform a pilot study to test the ability of PPA with PGx to inform whether dual anti-platelet therapy (DAPT) is appropriate and test the consequence of targeted therapy on PPA profile. If successful, this will allow patients that may most benefit to be identified, and those that might bleed to be avoided. This will pave the way for future clinical studies to test the efficacy of targeted anti-platelet therapy for primary and secondary prevention of thrombosis.