| Title: | Immediate platelet inhibition strategy for comatose out-of-hospital cardiac arrest survivors undergoing percutaneous coronary intervention and mild therapeutic hypothermia |
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| Authors: | ID Kordiš, Peter (Author)
ID Berden, Jernej (Author)
ID Mikuž, Urša (Author)
ID Noč, Marko (Author) |
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| Files: |  PDF - Presentation file, download (953,31 KB)
MD5: 7083F7D9B1F4F9C7C11685F27FA68E22
 URL - Source URL, visit https://www.mdpi.com/2077-0383/13/7/2121
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| Language: | English |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: |  UKC LJ - Ljubljana University Medical Centre
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| Abstract: | 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. |
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| Keywords: | cangrelor, cardiac arrest, platelet inhibition, percutaneous coronary intervention, stent thrombosis |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2024 |
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| Number of pages: | str. 1-13 |
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| Numbering: | Vol. 13, iss. 7, [article no.] 2121 |
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| PID: | 20.500.12556/DiRROS-30014  |
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| UDC: | 616.1 |
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| ISSN on article: | 2077-0383 |
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| DOI: | 10.3390/jcm13072121 |
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| COBISS.SI-ID: | 194020099 |
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| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 26. 4. 2024;
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| Publication date in DiRROS: | 11.06.2026 |
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| Views: | 85 |
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| Downloads: | 60 |
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