{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T02:57:04Z","timestamp":1790909824025,"version":"4.1.0"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T00:00:00Z","timestamp":1706572800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Antithrombotic therapy in acute patients with both high ischaemic and bleeding risks remains challenging.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We presented a challenging case involving a 48-year-old man referred to our hospital for headache and a left superior quadrantanopia. A CT scan revealed a right inferior occipital lobe ischaemic stroke. During the hospital stay, the patients developed pulmonary embolism (PE), and ST-elevation myocardial infarction (STEMI). A triple antithrombotic therapy was indicated, but the patient presented with high bleeding (anaemia, active malignancy, ischaemic stroke) and ischaemic (ischaemic stroke, PE, and superimposed STEMI) risks. In this critical acute setting, prolonged cangrelor infusion of reduced dosage, coupled with aspirin and enoxaparin, proved an effective and safe antithrombotic approach.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Prolonged cangrelor bridging at a reduced dose of 0.75\u2005\u03bcg\/kg\/min may represent an effective and safe option in acute patients requiring P2Y12 inhibition and presenting both high ischaemic and high bleeding risks.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae066","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T18:55:41Z","timestamp":1706640941000},"source":"Crossref","is-referenced-by-count":1,"title":["Cangrelor in a challenging scenario of concomitant ischaemic stroke, pulmonary embolism, and ST-elevation myocardial infarction: a case report"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5946-0827","authenticated-orcid":false,"given":"Federico","family":"Oliveri","sequence":"first","affiliation":[{"name":"Division of Cardiology, University of Pavia , Via Strada Nuova, 65, 27100 Pavia PV , Italy"},{"name":"Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, 2333 ZA, Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Tua","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Pavia , Via Strada Nuova, 65, 27100 Pavia PV , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Camporotondo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Gritti","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2447-7685","authenticated-orcid":false,"given":"Sergio","family":"Leonardi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Pavia , Via Strada Nuova, 65, 27100 Pavia PV , Italy"},{"name":"Division of Cardiology, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,30]]},"reference":[{"key":"2024021514565493200_ytae066-B1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1093\/eurheartj\/ehx419","article-title":"2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: the task force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"39","author":"Valgimigli","year":"2018","journal-title":"Eur Heart J"},{"key":"2024021514565493200_ytae066-B2","doi-asserted-by":"crossref","first-page":"2318","DOI":"10.1056\/NEJMoa0908628","article-title":"Platelet inhibition with cangrelor in patients undergoing PCI","volume":"361","author":"Harrington","year":"2009","journal-title":"N Engl J Med"},{"key":"2024021514565493200_ytae066-B3","doi-asserted-by":"crossref","first-page":"2330","DOI":"10.1056\/NEJMoa0908629","article-title":"Intravenous platelet blockade with cangrelor during PCI","volume":"361","author":"Bhatt","year":"2009","journal-title":"N Engl J Med"},{"key":"2024021514565493200_ytae066-B4","doi-asserted-by":"crossref","first-page":"371","DOI":"10.4244\/EIJ-D-20-00052","article-title":"Validation of the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria in patients undergoing percutaneous coronary intervention and comparison with contemporary bleeding risk scores","volume":"16","author":"Ueki","year":"2020","journal-title":"EuroIntervention"},{"key":"2024021514565493200_ytae066-B5","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1056\/NEJMoa1910021","article-title":"Polymer-based or polymer-free stents in patients at high bleeding risk","volume":"382","author":"Windecker","year":"2020","journal-title":"N Engl J Med"},{"key":"2024021514565493200_ytae066-B6","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1007\/s11239-012-0737-3","article-title":"Pharmacodynamic effects of cangrelor and clopidogrel: the platelet function substudy from the cangrelor versus standard therapy to achieve optimal management of platelet inhibition (CHAMPION) trials","volume":"34","author":"Angiolillo","year":"2012","journal-title":"J Thromb 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