Laboratory definition of "therapeutic window" of antiplatelet drugs. Results of the Real-life Acute Coronary Syndrome Registry (CARDIO-CCH)

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To define the optimal laboratory reference intervals for platelet function test in patients with acute coronary syndrome (ACS) on dual-antiplatelet therapy (DAPT).

Material and methods

Four hundred twenty five patients with ACS were enrolled in the single center prospective cohort registry (CARDIO-CCH). Platelet function testing (PFT) was performed in all patients (Chrono-Log Corporation, USA). Thirty day major adverse cardiac events (MACE) were recorded and matched up with the results of PFT to calculate "therapeutic window".


Upper "therapeutic window" cut-off point associated with an acceptable risk of ischemic events was calculated at the level of 45%. It is recommended to use 30% PFT rate as a lower cut-off limit which was associated with an increased risk of hemorrhagic events. However, lower cut-off point needs further investigations.


Optimal "therapeutic window" for PFT in patients with ACS on DAPT is in the interval from 30% to 45%.

Key words

Acute coronary syndrome, platelet aggregation, thrombosis, bleedings, antiplatelet therapy.