Academic Journal
P2815Antiplatelet therapy with cangrelor in patients undergoing surgery after coronary stent implantation: a real-world bridging protocol experience
| العنوان: | P2815Antiplatelet therapy with cangrelor in patients undergoing surgery after coronary stent implantation: a real-world bridging protocol experience |
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| المؤلفون: | Rossini, R, Masiero, G, Fruttero, C, Passamonti, E, Calvaruso, E, Cecconi, M, Carlucci, C, Barzaghi, N, Locatelli, A, Mojoli, M, Parodi, G, Talanas, G, Pierini, S, Angiolillo, D, Musumeci, G |
| المصدر: | European Heart Journal ; volume 40, issue Supplement_1 ; ISSN 0195-668X 1522-9645 |
| بيانات النشر: | Oxford University Press (OUP) |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Cardiology and Cardiovascular Medicine |
| الوصف: | Background Perioperative management of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in patients deemed at high thrombotic risk undergoing non-deferrable surgery remains poorly defined. Cangrelor represents a potential treatment option as a “bridge” from discontinuation of oral P2Y12 receptor antagonists to surgical procedures, but data in this setting are still scant. Purpose We sought to describe a real-world experience of a bridging protocol using cangrelor for patients referred to relevant bleeding risk surgery requiring withdrawal of DAPT. Methods We collected data from 7 Italian centers on patients with previous PCI, still on DAPT, undergoing non-deferrable surgery which required discontinuation of one or both antiplatelet agents. A standardized bridging protocol using cangrelor infusion before and eventually after surgery was applied (Figure 1). Results Between December 2017 and January 2019, a total of 18 patients (mean age 70±10 years; male 85%) were enrolled. In the majority (89%) of patients, the index PCI was performed due to acute coronary syndrome (ACS) and 2±1.7 stents per patient were implanted. All patients required non-deferrable, intermediate-high bleeding risk surgery as pulmonary lobectomy, colectomy, endoscopic bladder surgery, paranasal sinus surgery, coronary artery by-pass surgery and valvular repair, hip replacement, endoscopy sphincterotomy. High thrombotic risk categories included PCI time <1 month, SCA time <3 months, stent failure occurrence, previous Absorb BVS implantation. Due to the surgical bleeding risk, discontinuation of P2Y12 inhibitor was required 5 days before surgery (ticagrelor, n=13; prasugrel=1; clopidogrel, n=5). All patients but 1 maintained aspirin through the perioperative phase. Cangrelor infusion was started at a bridging dose (0.75 mcg/kg/min) 3 days before planned surgery and was discontinued 6.9±1.5 hours before. After surgery, drainages were left in all patients but 3. In 56% of patients, cangrelor was resumed ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1093/eurheartj/ehz748.1127 |
| الاتاحة: | http://dx.doi.org/10.1093/eurheartj/ehz748.1127 http://academic.oup.com/eurheartj/article-pdf/40/Supplement_1/ehz748.1127/30203191/ehz748.1127.pdf |
| Rights: | https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model |
| رقم الانضمام: | edsbas.33D044D9 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1093/eurheartj/ehz748.1127 |
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