Optimizing Antiplatelet Therapy in Cardiogenic Shock-Pharmacodynamics of Antiplatelet Therapies with and without CS, Dr. Frank Amico

Pharmacodynamics of Antiplatelet Therapies with and without CS, Dr. Frank Amico

Video Transcription

Video Summary

The talk discusses antiplatelet pharmacodynamics in cardiogenic shock, emphasizing altered drug absorption, metabolism, and distribution in this state. Oral agents like clopidogrel require liver activation, while ticagrelor is active orally. Cardiogenic shock delays oral absorption, making IV agents like cangrelor valuable for immediate platelet inhibition. The CANTIC and SCAR studies highlight cangrelor’s prompt, potent inhibition and association with reduced major adverse cardiac events in cardiogenic shock patients, though increased bleeding was noted in cardiac arrest cases. The DAPT shock AMI trial showed IV cangrelor achieved rapid platelet inhibition but no clear clinical superiority over ticagrelor. More trials are needed to guide therapy in shock.

Keywords

antiplatelet pharmacodynamics

cardiogenic shock

clopidogrel

ticagrelor

cangrelor