Background All cases of ACS treated with the same doses antiplatelet remedy without considering their results from it is not an optimal remedy obviously. TEG-Mapping assay can offer us a possibility to detect the activity of platelet in general clinical therapy process.

Objectives To evaluate the antiplatelet therapy results immediately post- PCI in high risk ACS patients.

Methods All ACS patients (n=310) with elective PCI took aspirin loading dose 300 mg before PCI and followed by 100 mg/day and clopidogrel loading dose 600 mg before PCI and followed by 75 mg/day therapy. Potential and residual platelet activity in ADP and AA pathway were detected respectively after 24–48 h from PCI with modified TEG-mapping assay.

Results (1) Most of the people have a moderate maximal potential platelet activity except 7.1% with very low level and 14.3% with very high level potential platelet activity. (2) Through residual platelet activity detecting, it can be seen that patients who are sensitive in ADP pathway are not necessarily sensitive in AA pathway, and vice-versa. (3) The frequency percent from clopidogrel is 22.0% in inhibition rate of platelet activation less than 50% group, 18.8% in that more than 90% group. But that from aspirin is 14.6% and 26.5%, p=0.0778 between the two pathways.

Conclusions Potential platelet activities are not same in different patients; Residual platelet activities are also different; Even for the same patient, the platelet inhibition ability derived from Aspirin is different from that from Clopidegrel. These individual differences in platelet activity further prove the necessity for case by case analysis and remedy adjustment.