Heparin-induced thrombocytopenia (HIT) is a rare but serious immune complication of heparin exposure that paradoxically increases the risk of thrombosis. In patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), heparin is essential to prevent circuit clotting, yet contraindicated in HIT. Available alternatives carry significant limitations. Cangrelor, an intravenous reversible P2Y12 inhibitor, has shown promise in case reports and small series in this context, but no multicenter study exists. CATCH-IT is a multicenter retrospective observational study conducted across 11 French cardiac surgery centers, aiming to describe the safety and efficacy of cangrelor combined with heparin during CPB in confirmed HIT patients, by estimating the incidence of major bleeding and thrombotic events within 7 days after surgery.
Age ≥ 18 years
Confirmed or highly probable HIT: 4T score ≥ 3 AND positive anti-PF4 antibodies (ELISA or equivalent), and when available, positive functional platelet test
Cardiac or aortic surgery with cardiopulmonary bypass (CPB)
Cangrelor administered in the perioperative period
None
* Age \< 18 years * HIT not confirmed or ruled out * Patient objection to data use * Surgery performed without CPB * Requirement for continued cangrelor in the postoperative period * Post-cardiotomy ECMO
Other
Retrospective
Not listed
Incidence of major hemorrhagic and/or thrombotic events
Proportion of patients experiencing at least one major hemorrhagic event (BARC grade ≥3, including hemoglobin drop ≥3 g/dL, red blood cell transfusion attributed to bleeding, need for interventional procedure, hemorrhagic shock, or documented intracranial hemorrhage) and/or thrombotic complication (imaging-confirmed ischemic stroke, acute mesenteric ischemia requiring surgery, acute limb ischemia, or vascular thrombosis) within 7 days after surgery.
Cangrelor dosing modalities
Description of dose used during CPB (cardiopulmonary bypass)
Cangrelor dosing modalities
Description monitoring during CPB (cardiopulmonary bypass)
Cangrelor dosing modalities
Description of dose adjustments during CPB (cardiopulmonary bypass)
Cangrelor dosing modalities
Description of duration of drug during CPB (cardiopulmonary bypass)
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