. "Widimsk\u00FD, Petr" . "10"^^ . "Thienopyridines are among the most widely prescribed medications, but their use can be complicated by the unanticipated need for surgery. Despite increased risk of thrombosis, guidelines recommend discontinuing thienopyridines 5 to 7 days prior to surgery to minimize bleeding. To evaluate the use of cangrelor, an intravenous, reversible P2Y(12) platelet inhibitor for bridging thienopyridine-treated patients to coronary artery bypass grafting (CABG) surgery. Prospective, randomized, double-blind, placebo-controlled, multicenter trial, involving 210 patients with an acute coronary syndrome (ACS) or treated with a coronary stent and receiving a thienopyridine awaiting CABG surgery to receive either cangrelor or placebo after an initial open-label, dose-finding phase (n=11) conducted between January 2009 and April 2011. Thienopyridines were stopped and patients were administered cangrelor or placebo for at least 48 hours, which was discontinued 1 to 6 hours before CABG surgery. Main Outcome Measures The primary efficacy end point was platelet reactivity (measured in P2Y(12) reaction units [PRUs]), assessed daily. The main safety end point was excessive CABG surgery-related bleeding. The dose of cangrelor determined in 10 patients in the open-label stage was 0.75 mu g/kg per minute. In the randomized phase, a greater proportion of patients treated with cangrelor had low levels of platelet reactivity throughout the entire treatment period compared with placebo; relative risk. There were no significant differences in major bleeding prior to CABG surgery, although minor bleeding episodes were numerically higher with cangrelor. Among patients who discontinue thienopyridine therapy prior to cardiac surgery, the use of cangrelor compared with placebo resulted in a higher rate of maintenance of platelet inhibition."@en . "Bridging Antiplatelet Therapy with Cangrelor in Patients Undergoing Cardiac Surgery a Randomized Controlled Trial"@en . "1"^^ . "JAMA-Journal of the American Medical Association" . . "N" . "RIV/00216208:11120/12:43907018!RIV14-MSM-11120___" . . . . . . . "Bridging Antiplatelet Therapy with Cangrelor in Patients Undergoing Cardiac Surgery a Randomized Controlled Trial"@en . . "stopping clopidogrel; premature discontinuation; platelet inhibition; st-segment elevation; acute myocardial-infarction; glycoprotein iib/iiia inhibitors; acute coronary syndromes"@en . "125530" . . "29"^^ . . "[6B68C0F159F7]" . . . . "3" . "Bridging Antiplatelet Therapy with Cangrelor in Patients Undergoing Cardiac Surgery a Randomized Controlled Trial" . . "RIV/00216208:11120/12:43907018" . . "0098-7484" . "US - Spojen\u00E9 st\u00E1ty americk\u00E9" . . "000299161200022" . "Thienopyridines are among the most widely prescribed medications, but their use can be complicated by the unanticipated need for surgery. Despite increased risk of thrombosis, guidelines recommend discontinuing thienopyridines 5 to 7 days prior to surgery to minimize bleeding. To evaluate the use of cangrelor, an intravenous, reversible P2Y(12) platelet inhibitor for bridging thienopyridine-treated patients to coronary artery bypass grafting (CABG) surgery. Prospective, randomized, double-blind, placebo-controlled, multicenter trial, involving 210 patients with an acute coronary syndrome (ACS) or treated with a coronary stent and receiving a thienopyridine awaiting CABG surgery to receive either cangrelor or placebo after an initial open-label, dose-finding phase (n=11) conducted between January 2009 and April 2011. Thienopyridines were stopped and patients were administered cangrelor or placebo for at least 48 hours, which was discontinued 1 to 6 hours before CABG surgery. Main Outcome Measures The primary efficacy end point was platelet reactivity (measured in P2Y(12) reaction units [PRUs]), assessed daily. The main safety end point was excessive CABG surgery-related bleeding. The dose of cangrelor determined in 10 patients in the open-label stage was 0.75 mu g/kg per minute. In the randomized phase, a greater proportion of patients treated with cangrelor had low levels of platelet reactivity throughout the entire treatment period compared with placebo; relative risk. There were no significant differences in major bleeding prior to CABG surgery, although minor bleeding episodes were numerically higher with cangrelor. Among patients who discontinue thienopyridine therapy prior to cardiac surgery, the use of cangrelor compared with placebo resulted in a higher rate of maintenance of platelet inhibition." . "Bridging Antiplatelet Therapy with Cangrelor in Patients Undergoing Cardiac Surgery a Randomized Controlled Trial" . "307" . "11120" . . .