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4CPS-061 Safety and effectiveness of the off-label use of cangrelor in perioperative bridging: a case series
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  1. J Santander Reboreda1,
  2. P Lalueza Broto1,
  3. P Marrero Ávarez1,
  4. M Bosch Ferrer2,
  5. HC García Diaz1,
  6. D Anguita Domingo1,
  7. MQ Gorgas Torner1
  1. 1Vall d’hebron University Hospital, Hospital Pharmacy Department, Barcelona, Spain
  2. 2Vall d’hebron University Hospital, Farmacology Department, Barcelona, Spain

Abstract

Background and Importance Cangrelor has been proposed for the off-label indication of antiplatelet bridging prior to surgery in patients at high risk for thrombotic complications in urgent or non-delayable surgery or procedure, particularly in those who have had recent coronary stenting and are therefore at higher risk for subacute stent thrombosis.

Aim and Objectives To determine the safety and effectiveness of cangrelor bridging therapy for patients undergoing urgent invasive procedures.

Material and Methods Retrospective observational study that included all patients who received cangrelor for off-label bridging purposes from January 2022 and June 2023 in a tertiary hospital.

Demographic, clinical and those variables related with the treatment were captured from pharmacy and medical electronic records.

Related to efficacy, we report in-hospital mortality and thrombotic events, including stroke and myocardial infarction, during 30 days after cangrelor administration. Related to safety, bleeding was only considered associated with cangrelor if it occurred during administration or up to 48 hours after discontinuation according to Bleeding Academic Research Consortium (BARC) 3–5.

Results Seven patients were identified (100% male; median age 71 years (interquartile range: 59–79)). All of them had coronary arterial stenting within the previous 1 month. The rest of patient and treatment characteristics can be found at the table 1.

Abstract 4CPS-061 Table 1

No patient in the study developed in-stent thrombosis or other thrombotic complication while receiving cangrelor neither withing 30 days of stopping therapy. No patient experienced clinically relevant bleeding according to BARC.

Conclusion and Relevance This study of patients receiving cangrelor as short-term antiplatelet therapy prior to surgical procedures with history of coronary stent placement demonstrated that a low dose of 0,75 mcg/kg/min provided adequate effectiveness and safety.

Conflict of Interest No conflict of interest.

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