Discontinuation of both cangrelor and ticagrelor because of severe dyspnea during primary angioplasty: a case report.

A 77-year-old man was admitted to our hospital for typical long-lasting chest pain. ECG showed an inferior STElevation Myocardial Infarction (STEMI), so the patient was pretreated with 250 mg of intravenous acetylsalicylic acid and transferred to the cath lab. Coronary angiography was performed via a radial approach after 5000 IU of heparin and showed total occlusion of the mid right coronary artery (Fig. 1). As the patient was P2Y12-inhibitor naı̈ve and the thrombotic burden was high, an infusion of cangrelor was initiated, after a 30 mg/kg/min bolus, at 4 mg/kg/min. Two 90-mg tablets of ticagrelor were crushed and administered. Two everolimus-eluting stents, Xience Sierra 4 18 mm and 4 15 mm, were implanted on the mid right coronary artery with a good result and restoration of TIMI III flow.