Abstract Funding Acknowledgements Type of funding sources: None. Introduction Based on the PLATO-trial and its sub-studies, ticagrelor can be used for patients with an acute coronary syndrome (ACS). Some of these patients are not awake or not able to swallow tablets. Alternatively the tablets can be crushed and given through a nasogastric tube. An extra obstacle for adequate intake is medication-induced gastroparesis caused by sedatives. Purpose The first aim of the study was to evaluate the platelet function analyser closure time (CT) in patients treated with crushed ticagrelor, after successful being resuscitated after cardiac arrest of acute ischaemic origin. Either they underwent PCI or urgent CABG, either they were treated conservatively. The second aim of the study was to determine plasma concentrations of ticagrelor and its main active metabolite AR-C124910XX. Methods We included 20 patients after successful resuscitation for cardiac arrest of acute ischaemic origin (16 STEMI + 4 NSTEMI). Only 1 patient was treated conservatively, 2 patients underwent an urgent CABG, the remainder were treated with PCI. All patients received a loading dose of ticagrelor before starting daily therapy. As patients were not able to swallow, tablets were crushed and given through a nasogastric tube. Measurements for Platelet Function Analysis were done at 0h, 2h, 4h, 8h, 12h, 24h and at day 4 + 4h. Platelet inhibition was tested with Platelet Function Analyser (PFA) activated by Adenosine Di Phosphate (ADP). A closure time (CT) longer than 113 seconds indicates full platelet inhibition by ticagrelor. Plasma concentration were determined at 30min, 1h, 2h, 4h, 8h, 24h and day 4 + 4h. Plasma concentrations were measured after protein precipitation, by using liquid chromatography with mass spectrometry detection. Results Out of 20 resuscitated patients enlisted in this study, 13 were still alive at day 4. At 24h, more than 80% of the survivors showed platelet inhibition as proven by a CT >113s. In 92% of the survivors, the PFA showed platelet inhibition at day 4 with a median CT of > 300s. For ticagrelor, the median time to peak plasma concentration (Tmax) was 100h [8; 100] for a median Cmax of 615.5 ng/ml [217.5; 1385.0]. The geometric mean was 467 ng/ml (248.5; 877.4). For the metabolite of ticagrelor, AR-C124910XX, median Tmax was 100h [8; 100] for a Cmax of 131.0 ng/ml [52.1; 177.7]. The geometric mean for the metabolite was 69.5 ng/ml (32.4; 149.0). Conclusions At day 4 of therapy, 92% of the survivors showed a CT longer than 113s, meaning full platelet inhibition by ticagrelor. In more than 80%, this was even the case at 24h. The median time to reach peak concentrations was 4 days, which is comparable to pharmacokinetic studies with ticagrelor in healthy volunteers. It should be noted that the dispersion in achieving Cmax is wide and can be reached earlier than at 4 days.