Add-on Cangrelor in STEMI-triggered Cardiac Arrest
Status:
Recruiting
Trial end date:
2021-12-01
Target enrollment:
Participant gender:
Summary
In patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary
angioplasty (PCI) P2Y12 receptor (P2Y12r) inhibition should be achieved as soon as possible.
Resuscitated STEMI-patients receiving targeted temperature management (TTM, therapeutic
hypothermia) after cardiac arrest, however, show deteriorated and delayed early response to
available oral P2Y12r inhibitors. Therapeutic hypothermia attenuates the drugs' effectiveness
by reducing its gastrointestinal absorption and metabolic activation. Acute stent thrombosis
is 5-fold increased after angioplasty following resuscitated cardiac arrest because of
insufficient early platelet suppression. Thus, aggressive antiplatelet strategies are needed
to achieve optimal platelet suppression during PCI in those patients. The first intravenous
P2Y12r inhibitor, cangrelor, has recently received marketing authorization for the acute
treatment of STEMI. We hypothesize that add-on antiplatelet therapy with intravenous
Cangrelor on-top of standard dual anti platelet therapy (DAPT) with Prasugrel or Ticagrelor
is superior to standard antiplatelet therapy alone in terms of suppressing ADP-dependent
platelet activation in resuscitated STEMI-patients receiving TTM.