High rates of prasugrel and ticagrelor non-responder in patients treated with therapeutic hypothermia after cardiac arrest

Ibrahim, Karim; Christoph, Marian; Schmeinck, S.; Schmieder, K.; Steiding, K.; Schoener, Lisa; Pfluecke, Christian; Quick, Silvio; Mues, Christoph; Jellinghaus, Stefanie; Wunderlich, Carsten; Strasser, R. H.; Kolschmann, Steffen

doi:10.1016/j.resuscitation.2014.02.004

Cited by 113 publications

(114 citation statements)

References 40 publications

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“…In the present study 50% of the patients with dual platelet inhibition did not reach the target VASP PRI <50% at the first sampling occasion (T1), thus placing them at risk for thromboembolic events. This is in agreement with previous findings of impaired bioavailability of clopidogrel in critically ill patients [44] and comparable with the results from Bjelland et al [31] and Ibrahim et al [32], which demonstrated high rates of non-responders in clopidogrel-treated patients (100% and 83%, respectively) as well as in ticagrelortreated patients (61%) [45] in MIH after cardiac arrest. In the present study we also demonstrated significant correlation between gastric emptying and VASP during hypothermia (Figure 3), indicating that gastric emptying is responsible for the limited ticagrelor effect observed at T1.…”

Section: Discussionsupporting

confidence: 93%

“…This finding is in agreement with the results of previous studies [23,24,26,33,37,44,45] using other reagents.…”

Section: Reduced Coagulation Abilitysupporting

confidence: 94%

“…The explanation for this discrepancy may be related to the fact that Sonoclot and thromboelastography fail to detect changes in platelet activation, whereas fl ow cytometry is designed to do this. The powerful platelet inhibition, exerted by ASA and P2Y 12 blockade, not detectable by Sonoclot, is probably more important for prevention of coronary reocclusion than the delayed ACT, decreased CR, and PF as measured with Sonoclot [45,46].…”

Section: Discussionmentioning

confidence: 97%

“…Studies including patients treated with MIH after OHCA are more infrequent. In two such studies [44,45], thromboelastography analyses showed evidence of decreased coagulation with prolonged clot initiation during hypothermia.…”

Section: Hemostasis In Mild Induced Hypothermiamentioning

confidence: 99%

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Aspects of bleeding complications and hemostasis at central line insertion and mild induced hypothermia

Kander

2014

Acta Anaesthesiol Scand

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Section: Discussionsupporting

confidence: 93%

“…This finding is in agreement with the results of previous studies [23,24,26,33,37,44,45] using other reagents.…”

Section: Reduced Coagulation Abilitysupporting

confidence: 94%

Section: Discussionmentioning

confidence: 97%

Section: Hemostasis In Mild Induced Hypothermiamentioning

confidence: 99%

See 2 more Smart Citations

Aspects of bleeding complications and hemostasis at central line insertion and mild induced hypothermia

Kander

2014

Acta Anaesthesiol Scand

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“…More recently, Ibrahim et al (2014) investigated the effect of hypothermia on the PDs of three antiplatelet agents, clopidogrel, prasugrel, and ticagrelor, in patients with acute coronary syndrome. In this study, they demonstrated that the platelet-inhibiting effect of all three drugs was significantly decreased under hypothermic conditions.…”

Section: Effect Of Ttm On Pharmacodynamicsmentioning

confidence: 99%

Effect of Hypothermia and Targeted Temperature Management on Drug Disposition and Response Following Cardiac Arrest: A Comprehensive Review of Preclinical and Clinical Investigations

Anderson

Poloyac

Kochanek

et al. 2016

Therapeutic Hypothermia and Temperature Management

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Targeted temperature management (TTM) has been shown to reduce mortality and improve neurological outcomes in out-of-hospital cardiac arrest (CA) patients and in neonates with hypoxic-ischemic encephalopathy (HIE). TTM has also been associated with adverse drug events in the critically ill patient due to its effect on drug pharmacokinetics (PKs) and pharmacodynamics (PDs). We aim to evaluate the current literature on the effect of TTM on drug PKs and PDs following CA. MEDLINE/PubMed databases were searched for publications, which include the MeSH terms hypothermia, drug metabolism, drug transport, P450, critical care, cardiac arrest, hypoxic-ischemic encephalopathy, pharmacokinetics, and pharmacodynamics between July 2006 and October 2015. Twenty-three studies were included in this review. The studies demonstrate that hypothermia impacts PK parameters and increases concentrations of cytochrome-P450-metabolized drugs in the cooling and rewarming phase. Furthermore, the current data demonstrate a combined effect of CA and hypothermia on drug PK. Importantly, these effects can last greater than 4-5 days post-treatment. Limited evidence suggests hypothermia-mediated changes in the Phase II metabolism and the Phase III transport of drugs. Hypothermia also has been shown to potentially decrease the effect of specific drugs at the receptor level. Therapeutic hypothermia, as commonly deployed/applied during TTM, alters PK, and elevates concentrations of several commonly used medications. Hypothermia-mediated effects are an important factor when dosing and monitoring patients undergoing TTM treatment.

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Technical consideration in acute myocardial infarction with cardiogenic shock: A review of antithrombotic and PCI therapies

Marquis‐Gravel

Zeitouni

Kochar

et al. 2019

Cathet Cardio Intervent

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In this review, we report a contemporary appraisal of the available evidence focusing on adjunctive antithrombotic therapy and technical aspects of percutaneous coronary interventions (PCI) in patients with acute myocardial infarction and cardiogenic shock (AMICS). Only few randomized trials have been conducted to evaluate the optimal arterial access choice, antithrombotic therapy, stent type, or the role of aspiration thrombectomy in this population. Observational data suggest that a transradial approach should be preferred for experienced operators, although knowledge and experience of transfemoral access is required to place any mechanical support device.In the absence of high-quality evidence to guide choice of the adjunctive antithrombotic drugs to support PCI in patients with AMICS, knowledge of the altered pharmacokinetics and pharmacodynamics in shock is required to inform decisions.Drug-eluting stents should be favored over bare-metal stents, and routine thrombectomy is not encouraged. Owing to the challenges inherent to the conduct of randomized trials in this acutely ill patient population, concerted multicenter, and international efforts are paramount to orchestrate the development of high-quality evidence to guide clinical practice.anticoagulant, antiplatelet, aspiration thrombectomy, cardiogenic shock, percutaneous coronary intervention, radial access

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High rates of prasugrel and ticagrelor non-responder in patients treated with therapeutic hypothermia after cardiac arrest

Cited by 113 publications

References 40 publications

Aspects of bleeding complications and hemostasis at central line insertion and mild induced hypothermia

Aspects of bleeding complications and hemostasis at central line insertion and mild induced hypothermia

Effect of Hypothermia and Targeted Temperature Management on Drug Disposition and Response Following Cardiac Arrest: A Comprehensive Review of Preclinical and Clinical Investigations

Technical consideration in acute myocardial infarction with cardiogenic shock: A review of antithrombotic and PCI therapies

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