A total of 11 patients were identified for inclusion. The median cangrelor dose was 0.5 µg/kg/min (interquartile range = 0.5-0.5) and was maintained in 7 of 11 patients. Doses ranged from 0.25 to 2 µg/kg/min during therapy, and 81.6% of VerifyNow results assessed were within goal range (⩽208 P2Y reaction units). Bleeding complications during therapy occurred in 3 patients, all of whom were receiving concomitant heparin infusions, and no stent thrombosis was reported. Conclusion and Relevance: Low-dose cangrelor may represent an effective option for bridging antiplatelet therapy in patients with coronary stents. This study demonstrated that the majority of patients received adequate platelet inhibition without any incidence of stent thrombosis on 0.5 µg/kg/min using the VerifyNow assay to monitor platelet inhibition, which represents a lower dose than previously reported in the literature.

There was no difference in the mean time from initiation of the infusion to the SBP goal between agents or in the secondary outcomes. Due to the lack of differences observed, each agent should be considered based on the patient care needs of the institution.

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Background: Patients with left ventricular assist devices (LVADs) are at high risk for bleeding and thrombotic events and may benefit from intensified anticoagulation management via a pharmacist-managed anticoagulation service.Aims: The aim of this quality improvement project was to implement and assess anticoagulation management by a pharmacist-managed warfarin anticoagulation service in LVAD patients. Materials and Methods:This was a pilot study to assess the outcomes of anticoagulation management by a pharmacist-managed outpatient anticoagulation service for the first 3 months following hospital discharge of patients with a newly implanted LVAD compared with a historical control group of LVAD patients managed by the previous standard-of-care. Time in therapeutic range and percent of international normalized ratio (INR) values within range were assessed as measures of anticoagulation. Twenty-six patients were in the intervention group and an equal number of controls were included for analysis. Results: Patients in the pharmacist-managed intervention group experienced a significantly greater INR time in therapeutic range than the control group (66% vs 46.9%; P = 0.003) and a greater percentage of INRs within therapeutic range (62.6% vs 43.8%; P = 0.002). Discussion and Conclusion: Pharmacist-managed anticoagulation was associated with improved INR control in this pilot group of LVAD patients in the first 3 months posthospital discharge.Additional study is warranted to determine if this benefit continues beyond 3 months, and to further assess clinical outcomes of thrombosis and bleeding events between groups. K E Y W O R D Santicoagulants, cardiology, heart failure, warfarin