20.500.12556/DiRROS-30014 Immediate platelet inhibition strategy for comatose out-of-hospital cardiac arrest survivors undergoing percutaneous coronary intervention and mild therapeutic hypothermia Background: Comatose survivors of out-of-hospital cardiac arrest (OHCA) undergoing percutaneous coronary intervention (PCI) and target temperature management (TTM) are at increased risk of stent thrombosis (ST), partly due to delayed platelet inhibition even with more potent P2Y12 agents. We hypothesized that periprocedural cangrelor would induce immediate platelet inhibition, bridging the "P2Y12 inhibition gap". Methods: In our pilot study, we randomized 30 comatose OHCA patients undergoing PCI and TTM (32-34 °C) into cangrelor and control groups. Both groups received unfractioned heparin, acetylsalicylic acid, and ticagrelor via enteral tube. The cangrelor group also received an intravenous bolus of cangrelor followed by a 4 h infusion. Platelet inhibition was measured using VerifyNow® and Multiplate® ADP at baseline and 1, 3, 5, and 8 h post PCI. Results: Patient characteristics did not differ between groups. VerifyNow® showed significantly decreased platelet reactivity with cangrelor at 1 h (30 vs. 221 PRU; p < 0.001) and 3 h (24 vs. 180 PRU; p < 0.001), with differences at 5 and 8 h. Similarly, the proportion of patients with high on-treatment platelet reactivity (HPR) in the cangrelor group was significantly lower at 1 h (0% vs. 67%; p < 0.001) and 3 h (0% vs. 47%; p = 0.007). Multiplate® ADP was also decreased at 1 h (14 vs. 48 U; p < 0.001) and 3 h (11 vs. 42 U; p = 0.001), with no difference at 5 and 8 h. The occurrence of bleeding events was similar in both groups. Conclusions: Cangrelor safely induced immediate and profound platelet inhibition. We observed no significant drug-drug interaction with ticagrelor. cangrelor cardiac arrest platelet inhibition percutaneous coronary intervention stent thrombosis kangrelor srčni zastoj zaviranje trombocitov perkutana koronarna intervencija tromboza stenta true false true Angleški jezik Slovenski jezik Neznano 2026-06-11 13:18:34 2026-06-11 13:18:34 2026-06-12 03:54:45 0000-00-00 00:00:00 2024 0 0 Nasl. z nasl. zaslona; Opis vira z dne 26. 4. 2024; str. 1-13 iss. 7, [article no.] 2121 Vol. 13 2024 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.1 2077-0383 10.3390/jcm13072121 194020099 RAZ_Kordis_Peter_2024.pdf RAZ_Kordis_Peter_2024.pdf 1 7083F7D9B1F4F9C7C11685F27FA68E22 271a5b536fd9ef64993f4d1b839017b301c3a24f387ac63b8e850e90bb9ddd9e 68777587-6587-11f1-9215-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=45236 https://www.mdpi.com/2077-0383/13/7/2121 1 49b6d85f-6587-11f1-9215-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=45235 Univerzitetni klinični center Ljubljana 0 0 0