Efficacy of Cangrelor as Bridging Therapy Post PCI.

Abstract

BACKGROUND:

Dual antiplatelet therapy (DAPT) remains the cornerstone management for the prevention of acute stent thrombosis after percutaneous intervention (PCI). Situations mandating early interruption of DAPT carry a high risk of ischemic complications. Perioperative bridge therapy using Cangrelor, an intravenous P2Y2 inhibitor, may offer a potential solution. Unfortunately, evidence for its use in non-cardiac procedures is limited.

METHODS:

Our protocol demonstrates successful off-label use of IV Cangrelor bridge therapy in a non-cardiac surgery patient. We describe a case of a 77-year old male; triple therapy with Aspirin, Apixaban, and Ticagrelor for recent drug-eluting stent placement required immediate surgical resection of stage I colonic adenocarcinoma.

RESULTS:

Cangrelor bridge therapy was utilized both preoperatively and postoperatively without ischemic or bleeding complications. The patient tolerated exploratory laparoscopic colectomy with minimal bleeding and good post-op recovery.

CONCLUSION:

Minimizing the interruption of DAPT therapy in high-risk patients is achievable. However, careful planning with a team-based approach involving surgeons, cardiologists and pharmacists, along with close clinical follow-up and vigilant management of anti-platelet therapy is recommended.

• Authors: Abdul A Khan, Ghulam Murtaza, Muhammad Khalid, Mathew Finniss, Thomas Helton
• Journal: Cardiovascular & hematological disorders drug targets (Cardiovasc Hematol Disord Drug Targets) Vol. 20 Issue 3 Pg. 227-231 ( 2020) ISSN: 2212-4063 [Electronic] United Arab Emirates
• PMID: 32108005 (Publication Type: Case Reports)
• Copyright: Copyright© Bentham Science Publishers; For any queries, please email at [email protected].

Chemical References

• Factor Xa Inhibitors
• Platelet Aggregation Inhibitors
• Purinergic P2Y Receptor Antagonists
• Pyrazoles
• Pyridones
• apixaban
• Adenosine Monophosphate
• cangrelor
• Ticagrelor
• Aspirin

Topics

• Adenosine Monophosphate (analogs & derivatives, therapeutic use)
• Aged
• Aspirin (therapeutic use)
• Colectomy (adverse effects, methods)
• Colonic Neoplasms (surgery)
• Drug-Eluting Stents (adverse effects)
• Factor Xa Inhibitors (therapeutic use)
• Humans
• Male
• Percutaneous Coronary Intervention (adverse effects, methods)
• Platelet Aggregation Inhibitors (therapeutic use)
• Purinergic P2Y Receptor Antagonists (therapeutic use)
• Pyrazoles (therapeutic use)
• Pyridones (therapeutic use)
• Thrombosis (etiology, prevention & control)
• Ticagrelor (therapeutic use)