The Use of Cangrelor in the Treatment of a Patient with COVID-19-Associated Acute Coronary Syndrome

Keywords: acute coronary syndrome, Cangrelor, coronary artery stenting, COVID-19, hypercoagulation, thrombosis

Abstract

In December 2019, an outbreak of pneumonia caused by a novel coronavirus occurred in Wuhan, Hubei province, spreading rapidly first throughout China and subsequently across Europe, the United States (US), and the rest of the world. On January 30, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a public health emergency of international concern, and on March 12, 2020, it was characterized as a pandemic. Patients exposed to this virus named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) frequently present with fever, cough, and shortness of breath within 2 to 14 days after exposure, and then usually develop coronavirus disease (COVID-19)-related pneumonia. Although respiratory symptoms prevail among all clinical manifestations of COVID-19, preliminary studies showed that some patients may develop severe cardiovascular (CV) damage.

To date, the COVID-19 pandemic has caused significant changes in the prevalence and pathogenesis of cardiovascular diseases among the population in Ukraine and other countries and has led to a significant increase in mortality in this category of patients. These changes necessitated adjustment of drug treatment in patients with concomitant COVID-19.

Conclusions. COVID-19 is a global pandemic with unpredictable consequences due to mutually reinforcing damage to the respiratory and cardiovascular systems. Treatment of acute coronary syndrome on the background of COVID-19 requires a systematic approach involving physicians of various specialties as well as compliance with anti-epidemic mea- sures. Interventional treatment is quite effective in treating patients with COVID-associated acute coronary syndrome.

COVID-19 patients on mechanical ventilation should use intravenous P2Y12 receptor blockers or drugs that can be crushed and administered through a nasogastric tube. Cangrelor, an intravenous P2Y12 receptor blocker with fast action and high controllability, enabled to achieve the optimal result of the intervention.

References

  1. Chieffo A, Stefanini GG, Price S, Barbato E, Tarantini G, Karam N, Moreno R, Buchanan GL, Gilard M, Halvorsen S, Huber K, James S, Neumann FJ, Möllmann H, Roffi M, Tavazzi G, Mauri Ferré J, Windecker S, Dudek D, Baumbach A. EAPCI Position Statement on Invasive Management of Acute Coronary Syndromes during the COVID-19 pandemic. Eur. Heart J. 2020 May 14;41(19):1839-1851. https://doi.org/10.1093/eurheartj/ehaa381.
  2. Ferlini M, Andreassi A, Carugo S, Cuccia C, Bianchini B, Castiglioni B, D’ Urbano M, Guagliumi G, Lettieri C, Lettino M, Marenzi G, Metra M, Migliori M, Montorfano M, Oliva F, Savonitto S, Seregni R, Visconti LO. Centralization of the ST elevation myocardial infarction care network in the Lombardy region during the COVID-19 outbreak. Int. J. Cardiol. 2020 Aug 1;312:24-26. https://doi.org/10.1016/j.ijcard.2020.04.062.
  3. Stefanini GG, Montorfano M, Trabattoni D, Andreini D, Ferrante G, Ancona M, Metra M, Curello S, Maffeo D, Pero G, Cacucci M, Assanelli E, Bellini B, Russo F, Ielasi A, Tespili M, Danzi GB, Vandoni P, Bollati M, Barbieri L, Oreglia J, Lettieri C, Cremonesi A, Carugo S, Reimers B, Condorelli G, Chieffo A. ST-Elevation Myocardial Infarction in Patients With COVID-19: Clinical and Angiographic Outcomes. Circulation. 2020 Jun 23;141(25):2113-2116. https://doi.org/10.1161/CIRCULATIONAHA.120.047525.
  4. Tam CF, Cheung KS, Lam S, Wong A, Yung A, Sze M, Lam YM, Chan C, Tsang TC, Tsui M, Tse HF, Siu CW. Impact of Coronavirus Disease 2019 (COVID-19) Outbreak on ST-Segment–Elevation Myocardial Infarction Care in Hong Kong, China. Circ Cardiovasc Qual Outcomes. 2020 Apr;13(4):e006631. https://doi.org/10.1161/CIRCOUTCOMES.120.006631.
Published
2021-06-29
How to Cite
1.
Salo SV, Levchyshyna OV, Gavrylyshyn AY, Logutov AK, Hladun AY. The Use of Cangrelor in the Treatment of a Patient with COVID-19-Associated Acute Coronary Syndrome. ujcvs [Internet]. 2021Jun.18 [cited 2024Dec.21];(2 (43):92-5. Available from: https://cvs.org.ua/index.php/ujcvs/article/view/425