A Study to Determine the Effects of Dual Anti-Platelet Therapy (DAPT) on Neutrophils.

The proposed study is to investigate whether neutrophils are affected by dual antiplatelet therapy. Platelets are blood clotting cells that usually act to repair damage to blood vessels. However, platelets also cause blood clotting in the arteries of the heart which can cause a heart attack. As such, dual antiplatelet therapy is the gold standard pharmacological management of a heart attack, which inhibits platelet activity to reduce the risk of recurrent cardiovascular events. Despite antiplatelet therapy, nearly a third of New Zealander’s will experience all-cause death, recurrent acute coronary syndrome (unstable angina or a heart attack), or will be readmitted to hospital due to their cardiovascular disease within 12 months of their heart attack. This recurrence is partially attributable to persistent platelet activity, although several studies have demonstrated that antiplatelet medications also elicit off-target effects on immune cells, which are known to be important for recovery after a heart attack. Neutrophils are the first type of immune cells to arrive to the site of cardiac injury after a heart attack, where they perform a variety of biological processes to clear debris and help recovery. Notably, the effects of antiplatelet therapy on neutrophils is understudied. Therefore we aim to investigate whether current antiplatelet medications have off-target effects on neutrophils. We hypothesise that dual anti-platelet therapy will affect neutrophil function.