ABSTRACT Background Patients with acute myocardial infarction‐related cardiogenic shock (AMI‐CS) with and without cardiac arrest (CA) may experience delayed onset and absorption of oral P2Y12 inhibitors potentially leading to acute adverse events. Aims To assess the efficacy and safety of Cangrelor in AMI‐CS with and without CA, focusing on early stent thrombosis rates, bleeding events, and cardiovascular mortality. Methods A total of 168 patients treated with Cangrelor for AMI‐CS (Society for Cardiovascular Angiography 95% CI 2.15 to 13.42; p < 0.001; multivariate p = 0.014). The mean cangrelor infusion dose was not linked to an increased bleeding risk (OR 1.00; 95% CI 1.00 to 1.00; p = 0.229). Preprocedural and discharge use of prasugrel, ticagrelor, or clopidogrel also showed no significant impact on BARC 3–5 bleeding (preprocedural p = 0.115, 0.223 and 0.831; discharge p = 0.455, 0.148 and 0.473, respectively). Following multivariate adjustment, the use of MCS, intensive care unit (ICU) duration, and reduced LVEF were the only predictors of bleeding risk ( p = 0.014, 0.010, and 0.042, respectively). Conclusion Cangrelor effectively prevents acute stent thrombosis and reinfarction within 48 h. Patients with MCS, longer ICU duration and reduced LVEF are at increased risk of bleeding complications. Cangrelor infusion duration per se was not associated with an increased risk of significant bleeding.
Bennar et al. (Mon,) studied this question.