The purpose of the research is to give the effectiveness and safety of ticagrelor in combination with acetylsalicylic acid as preoperative treatment of primary stenting in patients with ACS. We have investigated 42 patients with ACS, 3 of which were diagnosed with cardiogenic shock, age from 38 to 82 years (63 ± 6.5 years). The ACS diagnosis was verified using the results of the ECG, a troponin test and x-ray contrast coronary angiography. The purpose of preoperative antiplatelet treatment prior to primary PCI ticagrelor was administered in the dose of 180 mg and aspirin at a dose of 200 mg. Emergency coronary angiography and primary PCI was performed 15-90 minutes from the time of diagnosis. TIMI III flow in the infarct-related coronary arteries was achieved in all patients. None of the patients the phenomenon of "No-Reflow" has not developed. The appointment of the antiplatelet drug ticagrelor before primary PCI contributes to the achievement of full blood flow restoration in the infarct-related coronary artery, and also reduces the risk of intraoperative and postoperative complications.