According to the ESC guidelines, cangrelor may be considered in P2Y12-inhibitor-naïve acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). The aim of this review is to summarize available evidence on the optimal maintenance therapy with P2Y12 receptor inhibitor after cangrelor. Transitioning from cangrelor to a thienopyridine, but not ticagrelor, can be associated with a drug-drug interaction (DDI); therefore, a ticagrelor loading dose (LD) can be given any time before, during, or at the end of a cangrelor infusion, while a LD of clopidogrel or prasugrel should be administered at the time the infusion of cangrelor ends or within 30 minutes before the end of infusion in the case of a LD of prasugrel. Administration of any oral antiplatelet agent at the end of a cangrelor infusion will also result in a transient period of increased platelet reactivity. The inter-individual variability of this period is difficult to predict because it depends on many factors related to the patient and the treatment. In addition, experimental studies indicate that cangrelor may exert a cardioprotective effect beyond the blockade of platelet aggregation. Considering the available data, the potential use of cangrelor in ACS patients goes well beyond the current indications. Furthermore, we believe that it might be prudent to avoid use of thienopyridines during and soon after a cangrelor infusion until conclusive data on the effect of the DDI on the clinical outcome are available. On the other hand, ticagrelor seems to be an optimal oral agent for continuation of P2Y12 inhibition in patients receiving cangrelor infusion.

• Klíčová slova
• P2Y12 receptor inhibition, antiplatelet therapy, cangrelor, ticagrelor,
• MeSH
• adenosinmonofosfát * analogy a deriváty   aplikace a dávkování   škodlivé účinky   MeSH
• akutní koronární syndrom * farmakoterapie   terapie   krev   diagnóza   MeSH
• antagonisté purinergních receptorů P2Y * aplikace a dávkování   škodlivé účinky   MeSH
• inhibitory agregace trombocytů aplikace a dávkování   škodlivé účinky   MeSH
• koronární angioplastika * MeSH
• lékové interakce MeSH
• lidé MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• adenosinmonofosfát * MeSH
• antagonisté purinergních receptorů P2Y * MeSH
• cangrelor MeSH Prohlížeč
• inhibitory agregace trombocytů MeSH