Atment of acute ST-elevation myocardial infarction (STEMI) entails fast diagnosis, and transfer to a cardiac centre capable of percutaneous coronary intervention (PCI) for quick mechanical revascularisation. Thriving treatment needs fast return of perfusion towards the myocardium accomplished by thromboaspiration, passivation of the culprit lesion with stent scaffolding and systemic inhibition of thrombosis and platelet activation. A delicate balance exists amongst thrombosis and bleeding and consequently anti-thrombotic and antiplatelet remedy regimens continue to evolve. The wish to attain reperfusion as quickly as you possibly can, within the setting of high platelet reactivity, demands potent and fast-acting anti-thrombotic/anti-platelet therapies. The related bleeding threat could be minimised by use of short-acting anti-thrombotic intravenous agents. On the other hand, powerful oral platelet inhibition is essential to stop recurrent thrombosis. The interaction among baseline platelet reactivity, timing of revascularisation and efficient inhibition of thrombosis is yet to become formally investigated.Formula of 131180-63-7 Methods/Design: We present a protocol to get a prospective observational study in individuals presenting with acute STEMI treated with primary PCI (PPCI) and getting bolus/infusion bivalirudin and prasugrel therapy. The objective of this study should be to describe variation in platelet reactivity, as measured by the multiplate platelet function analyser, at presentation, the end from the PPCI procedure and 1, 2, 24 hours post-procedure. We intend to assess the prevalence of higher residual platelet reactivity inside 24 hours of PPCI in acute STEMI individuals getting prasugrel and bivalirudin. Additionally, we will investigate the association in between high platelet reactivity prior to and immediately after PPCI and also the door-to-procedure completion time. This is a single centre study using a target sample size of 108 participants. Discussion: The baseline platelet reactivity on presentation having a STEMI may perhaps influence around the impact of acute anti-thrombotic and anti-platelet therapy and expose individuals to a heightened danger of bleeding or ongoing thrombosis. This study will define the baseline variation in platelet reactivity in a population of patients experiencing acute STEMI and assess the pharmacodynamic response to combined remedy with bivalirudin and prasugrel. The information obtained from this trial is going to be hypothesis producing for future trials testing option pharmacotherapies inside the acute phase of treatment for STEMI. Trial registration: This study has approval from Wiltshire study ethics committee (10/H0106/87) and is registered with current controlled trials (controlled-trials/ISRCTN82257414).549531-11-5 supplier Keywords and phrases: Myocardial infarction, Percutaneous coronary intervention, Antiplatelet therapy, Anti-thrombotic therapy, Platelet function testing* Correspondence: Tom.PMID:24101108 [email protected] 1 Bristol Heart Institute, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, UK Complete list of author information and facts is out there in the end of your article?2014 Johnson et al.; licensee BioMed Central Ltd. This is an Open Access article distributed beneath the terms of your Inventive Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original perform is correctly credited.Johnson et al. BMC Cardiovascular Issues 2014, 14:44 http://biomedcentral/1471-2261/14/Page two ofBackground P.