Evaluation of the Effectiveness of Platelet-based and Microvesicle-based Assays to Predict Thrombotic and Bleeding Risk in Chronic Kidney Disease Patients With Acute Coronary Syndrome

This study is looking at blood tests in patients with both chronic kidney disease (CKD) and a recent heart attack or acute coronary syndrome (ACS), to better predict who is at risk for blood clots or dangerous bleeding. Kidney disease affects how blood clots, making treatment decisions tricky — this research aims to improve that. **You may be eligible if...** - You are between 18 and 90 years old - You have been diagnosed with acute coronary syndrome (heart attack or unstable chest pain requiring urgent care) - You have chronic kidney disease (eGFR at or below 60) - You are being treated at a hospital with a cardiac catheterization lab **You may NOT be eligible if...** - You are under 18, pregnant, or breastfeeding - You are already on long-term blood thinners (anticoagulants) - You have had a stroke or serious bleeding event recently - You have progressive cancer, severe liver failure, or an organ transplant - Your platelet count is very low or you have a bleeding disorder Talk to your doctor to see if this trial is right for you.