Cangrelor Bridge Therapy for Gastroduodenal Biopsy

William D Cahoon1,2, Allison K Oswalt1,2, Kerry E Francis1,2

  • 11 Department of Pharmacy, Virginia Commonwealth University Health System/Medical College of Virginia Hospitals, Richmond, VA, USA.

Insights

Dual antiplatelet therapy (DAPT) is crucial for preventing cardiac events after stenting. Cangrelor offers a potential bridging option for patients needing temporary DAPT interruption, balancing ischemic and bleeding risks.

Area of Science:

  • Cardiology
  • Pharmacology
  • Gastroenterology

Background:

  • Dual antiplatelet therapy (DAPT) is essential for secondary prevention in acute coronary syndromes and after coronary stent placement.
  • Premature DAPT cessation increases risks of cardiac ischemic events and mortality.
  • Bridging therapy is needed for urgent procedures but lacks FDA-approved options.

Observation:

  • A patient with a history of gastrointestinal bleeding was on DAPT for a drug-eluting stent.
  • The patient required a gastroduodenal biopsy, necessitating a temporary interruption of DAPT.
  • Cangrelor was administered as an antiplatelet bridge therapy before the procedure.

Findings:

  • Cangrelor served as a bridge therapy in a patient with a history of gastrointestinal bleeding on DAPT.
  • This case highlights a potential strategy for managing DAPT interruption in high-risk patients.

Implications:

  • Cangrelor may be a viable option for antiplatelet bridging therapy in specific clinical scenarios.
  • Further research is needed to establish guidelines for cangrelor use in DAPT bridging.
  • Balancing ischemic and bleeding risks remains critical when managing DAPT interruption.