Short-acting P2Y12 blockade to reduce platelet dysfunction and coagulopathy during experimental extracorporeal circulation and hypothermia

Abstract

Background. Extracorporeal circulation (ECC) and hypothermia are routinely used in cardiac surgery to maintain stable circulatory parameters and to increase the ischaemic tolerance of the patient. However, ECC and hypothermia cause platelet activation and dysfunction possibly followed by a devastating coagulopathy. Stimulation of the adenosinediphosphate (ADP) receptor P 2Y12 plays a pivotal role in platelet activation. This experimental study tested P2Y12 receptor blockade as an approach to protect platelets during ECC. Methods. Human blood was treated with the short-acting P2Y12 blocker cangrelor (1 μM, t 1/2<5 min) or the P2Y12 inhibitor 2-MeSAMP (100 μM) and circulated in an ex vivo ECC ..