Title:Efficacy of Cangrelor as Bridging Therapy Post PCI
VOLUME: 20 ISSUE: 3
Author(s):Abdul A. Khan, Ghulam Murtaza*, Muhammad Khalid, Mathew Finniss and Thomas Helton
Affiliation:Division of Cardiovascular Medicine, East Tennessee State University, TN, Division of Cardiovascular Medicine, East Tennessee State University, TN, Division of Cardiovascular Medicine, East Tennessee State University, TN, Department of Internal Medicine, East Tennessee State University, TN, Division of Cardiovascular Medicine, Mountain Home VA Medical Center, TN
Keywords:Bleeding, gastrointestinal, surgery, antiplatelet, coronary syndrome, hypertension.
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.
