• Jack C Pluenneke, Adham M Mohamed, Charles H Hayes, Timothy P Berry, Elizabeth L Thomas, Larisa Zhurav, Jonathan B Kozinn, Michelle M Haines, and Julie A Welge.
• Department of Pharmacy, Saint Luke's Hospital of Kansas City, Kansas City, MO; Saint Luke's Mid America Heart Institute, Kansas City, MO. Electronic address: jacpluenneke1@saintlukeskc.org.
• J. Cardiothorac. Vasc. Anesth. 2023 Dec 1; 37 (12): 251125162511-2516.

ObjectivesTo describe cangrelor use in patients on concurrent mechanical circulatory support who underwent postpercutaneous coronary intervention.DesignA single-center, retrospective, cohort study.SettingAt a quaternary teaching hospital.ParticipantsIncluded patients were ≥18 years old, admitted to the intensive care unit, underwent percutaneous coronary intervention with stent placement, initiated on mechanical circulatory support, and received cangrelor in the postpercutaneous coronary intervention period.InterventionsRetrospectively analyzed cangrelor use in patients on mechanical circulatory support.Measurements And Main ResultsThe primary outcome was the incidence of thrombosis and bleeding events during cangrelor administration. Additional outcomes included initial cangrelor dose, number of cangrelor dose adjustments per patient, survival from mechanical circulatory support, and mortality within 30 days. Overall, 19 patients were included in this study. In total, 14 patients (74%) experienced a bleeding event; however, 93% were classified as a minor bleed. There was 1 major bleeding event. There were no thrombotic events observed during cangrelor administration. The median initial cangrelor dose was 0.5 µg/kg/min. There were 10 patients who underwent dose adjustment, with the majority being dose reductions based on antiplatelet monitoring (VerifyNow assay). Survival from mechanical circulatory support occurred in 17 patients (89%), and 30-day mortality occurred in 8 patients (42%).ConclusionsFor patients receiving cangrelor as a bridge to oral P2Y12 inhibitor therapy on mechanical circulatory support, the authors observed a low rate of major bleeding and no episodes of thrombosis. Lower starting doses appear feasible with no observed increased risk of thrombotic complications. Future studies are needed to confirm these observations.Copyright © 2023 Elsevier Inc. All rights reserved.

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