Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02087-y
Efficacy and safety of cangrelor in patients undergoing PCI after cardio-pulmonary resuscitation and/or cardiogenic shock. Results of the CAN-Shock Registry.
U. Zeymer1, S. Richter2, C. Olivier3, K. Huber4, B. Haring5, P. L. Schwimmbeck6, M. Andrassy7, I. Akin8, A. Cuneo9, C. Lober10, F. Hassinger10, T. Geisler11, für die Studiengruppe: CAN-SHOCK
1Medizinische Klinik B, Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen am Rhein; 2I. Medizinische Klinik, Hegau-Bodensee-Klinikum Singen, Singen; 3Klinik für Kardiologie und Angiologie I, Universitäts-Herzzentrum Freiburg - Bad Krozingen, Freiburg im Breisgau; 43. Medizinische Abteilung mit Kardiologie, Klinik Ottakring, Wien, AT; 5Innere Medizin III - Kardiologie, Angiologie und internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar; 6Medizinische Klinik I - Kardiologie, Klinikum Leverkusen gGmbH, Leverkusen; 7Medizinische Klinik II, Fürst-Stirum-Klinik Bruchsal, Bruchsal; 8I. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim; 9Innere Medizin und Kardiologie, Krankenhaus & MVZ Maria-Hilf Stadtlohn GmbH, Stadtlohn; 10Stiftung Institut für Herzinfarktforschung, Ludwigshafen am Rhein; 11Innere Medizin III, Kardiologie und Kreislauferkrankungen, Universitätsklinikum Tübingen, Tübingen;

Background. Cangrelor is an intravenous P2Y12 inhibitor with an immediate onset of action and a short half-life. Its use seems especially attractive in patients who cannot swallow oral drugs, e.g. after CPR or in cardiogenic shock.

Purpose. To determine the efficacy and safety of the intravenous P2Y12 inhibitor cangrelor undergoing PCI after prehospital cardiopulmonary resuscitation (CPR) and/or cardiogenic shock (CS) in real life.

Methods: The CAN-SHOCK registry included patients undergoing PCI for acute myocardial infarction after CPR. Baseline characteristics, procedural features, and in-hospital outcomes were centrally collected and analysed. The primary endpoint was the incidence of stent thrombosis and/or myocardial reinfarction until 48 hours after PCI.

Results. A total of 303 patients were included in 10 centers in Austria and Germany. The inclusion criteria were CPR before PCI (n=169, 55.8 %), cardiogenic shock (n=68, 22.4 %) and CPR and cardiogenic shock (n=59, 19.5 %).  The baseline characteristics, in-hospital procedures and outcomes are listed in the table.    

Conclusions. In this large multicentre registry cangrelor in patients undergoing PCI after CPR and/or CS cangrelor was effective in preventing stent thrombosis and re-infarction and associated with an acceptable bleeding rate.

N

%

Age (years)

65.2 + 13.1

Women

67

22.1 %

STEMI

220

72.6 %

Left main PCI

20

6.6 %

LAD PCI

155

51.2 %

Multivessel PCI

111

36.6 %

TIMI 3 after PCI

286

94.4 %

Mechanical circulatory support

56

18.5 %

Hypothermia

129

45.6%

Stent thrombosis < 48  h

0

0

Stent thrombosis > 48 h

3

1.0 %

Re-infarction

0

0

BARC 2-5 bleeding

44

14.5 %

Total mortality

126

41.6 %

Cardiac mortality

44

14.5 %

https://dgk.org/kongress_programme/ht2022/aP722.html