AI Article Synopsis

  • Dual antiplatelet therapy (DAPT) is crucial for managing patients with coronary artery disease during procedures like percutaneous coronary intervention (PCI), but can pose risks if surgery is needed urgently.
  • Cangrelor, an intravenous medication, allows rapid and potent platelet inhibition, which can be quickly reversed, making it a potential solution for patients needing to temporarily stop DAPT.
  • In a case of a patient with recent PCI who developed an esophageal perforation, prolonged cangrelor use effectively helped manage the situation without causing any thrombotic or bleeding complications.

Article Abstract

Dual antiplatelet therapy (DAPT) is a vital part of the pharmacological management in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). While early discontinuation of DAPT increases ischemic risk, some patients on DAPT may require urgent surgery, necessitating its interruption. Cangrelor, an intravenous P2Y12 antagonist, provides strong platelet inhibition within minutes and platelet activity normalizes within one hour after the cessation of the drug. Bridging antiplatelet therapy with cangrelor has been increasingly studied as an alternative option to ensure the continuation of platelet inhibition in CAD patients who require discontinuation of DAPT. The present patient, with a recent history of PCI for acute coronary syndrome, experienced a significant esophageal perforation following transesophageal echocardiography (TEE). This severe complication was effectively managed endoscopically, and as part of the recent PCI treatment, prolonged cangrelor infusion was successfully utilized with no thrombotic or bleeding events throughout the management of the complication.

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Source
http://dx.doi.org/10.5543/tkda.2023.50000DOI Listing

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