Key result
Therapeutic hypothermia can alter the effectiveness and pharmacokinetic properties of antiplatelet agents, including P2Y12 inhibitors, through multiple mechanisms.
Why the study?
Studies report controversial and discrepant results regarding the effect of therapeutic hypothermia on blood coagulability, platelet reactivity, and antiplatelet drug effectiveness.
How does therapeutic hypothermia affect the effectiveness of antiplatelet drugs in patients after out-of-hospital cardiac arrest?
How does therapeutic hypothermia affect the effectiveness of antiplatelet drugs in patients after out-of-hospital cardiac arrest?
Therapeutic hypothermia alters the pharmacokinetics and pharmacodynamics of antiplatelet agents, necessitating special attention when managing out-of-hospital cardiac arrest patients.
Answers are grounded in this paper and cite their sources.
May impair antiplatelet response post-arrest; leaves open optimal DAPT strategy in TH patients.
Out‐of‐hospital cardiac arrest is among the most frequent causes of death worldwide. Immediate intervention, as well as dual antiplatelet therapy consisting of acetylsalicylic acid and a P2Y 12 inhibitor is often recommended. In line with the growing number of reports on cardiac arrest treatment, therapeutic hypothermia ( TH ) has been proposed for unconscious patients to improve neurological outcomes. Nevertheless, studies report controversial and often discrepant results on the effect of hypothermia on blood coagulability and platelet reactivity. In this review, we summarize the knowledge on platelet function under diverse hypothermic conditions. Additionally, we review the current literature on the effect of systemic hypothermia on pharmacokinetic and pharmacodynamic properties of antiplatelet agents. It has been shown that TH can alter the effectiveness of antiplatelet agents, including P2Y 12 inhibitors, through multiple mechanisms, hence, special attention should be paid while implementing antiplatelet therapy in patients under TH conditions.
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Eyileten et al. (2019) conducted a review in Out-of-hospital cardiac arrest. Therapeutic hypothermia was evaluated. Therapeutic hypothermia can alter the effectiveness and pharmacokinetic properties of antiplatelet agents, including P2Y12 inhibitors, through multiple mechanisms.
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