{"id":15371,"date":"2012-01-17T16:25:38","date_gmt":"2012-01-17T21:25:38","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=15371"},"modified":"2012-01-18T12:56:47","modified_gmt":"2012-01-18T17:56:47","slug":"cangrelor-proposed-as-bridge-to-surgery","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2012\/01\/17\/cangrelor-proposed-as-bridge-to-surgery\/","title":{"rendered":"Cangrelor Proposed as Bridge to Surgery"},"content":{"rendered":"<p>As a potent and reversible platelet inhibitor, cangrelor has been proposed for use in a bridging strategy for patients scheduled for surgery who are currently taking clopidogrel or another thienopyridine. To test this strategy, the\u00a0<a href=\"http:\/\/clinicaltrials.gov\/ct2\/show\/NCT00767507?term=cangrelor&amp;rank=6\">BRIDGE<\/a>\u00a0investigators randomized 210 ACS or stent patients awaiting CABG and taking a thienopyridine to receive either cangrelor or placebo for at least 48 hours prior to surgery.<\/p>\n<p>During the treatment period, platelet reactivity was lower in the cangrelor group than in the placebo group. There was no significant difference in the rate of surgery-related bleeding.<\/p>\n<ul>\n<li>Platelet inhibition (defined as PRU &lt;240) occurred in 98.8% of patients in the cangrelor group compared with 19.0% of patients in the placebo group (RR 5.2, CI 3.3-8.1, p&lt; 0.001).<\/li>\n<li>Excessive CABG surgery\u2013related bleeding occurred in 11.8% of the cangrelor group compared with 10.4% of the placebo group (RR \u00a01.1, CI 0.5-2.5, p=0.763).<\/li>\n<\/ul>\n<p><a href=\"http:\/\/jama.ama-assn.org\/content\/307\/3\/265.abstract\">Writing in <em>JAMA<\/em><\/a>, the researchers conclude:<\/p>\n<blockquote><p>Our data support the hypothesis that intravenous cangrelor is a feasible management strategy in patients waiting for cardiac surgery who require prolonged platelet P2Y<sub>12<\/sub>\u00a0inhibition after thienopyridine discontinuation.<\/p><\/blockquote>\n<p><em>(For our Interventional Cardiology co-moderators&#8217; take on this study, click <a href=\"http:\/\/blogs.nejm.org\/cardioexchange\/interventional\/cangrelor-and-alaska%E2%80%99s-%E2%80%9Cbridge-to-nowhere%E2%80%9D\/\">here<\/a>.)<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>As a potent and reversible platelet inhibitor, cangrelor has been proposed for use in a bridging strategy for patients scheduled for surgery who are currently taking clopidogrel or another thienopyridine. To test this strategy, the\u00a0BRIDGE\u00a0investigators randomized 210 ACS or stent patients awaiting CABG and taking a thienopyridine to receive either cangrelor or placebo for at [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20,1,9,7],"tags":[231,1106,334,1107],"class_list":["post-15371","post","type-post","status-publish","format-standard","hentry","category-cardiac-surgery","category-general","category-interventional-cardiology","category-prevention","tag-cabg","tag-cangrelor","tag-clopidogrel","tag-thienopyridines"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/15371","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=15371"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/15371\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=15371"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=15371"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=15371"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}