10 Jan Cangrelor With and Without Glycoprotein IIb/IIIa Inhibitors in Patients Undergoing PCI
MedicalResearch.com Interview with:
Deepak L. Bhatt, MD, MPH, FACC, FAHA, FSCAI, FESC
Executive Director of Interventional Cardiovascular Programs,
Brigham and Women’s Hospital Heart & Vascular Center
Professor of Medicine, Harvard Medical School
Boston, MA 02115
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Cangrelor is a potent, fast on, fast off, intravenous ADP receptor antagonist that is now available for use during PCI. Glycoprotein IIb/IIIa inhibitors are intravenous antiplatelet agents that work by a different mechanism. Doctors have asked whether there is any advantage to combining them or whether one class is preferable to the other during PCI.
We analyzed close to 25,000 patients from the CHAMPION trials. Cangrelor’s efficacy in reducing peri-procedural ischemic complications in patients undergoing PCI was present
irrespective of glycoprotein IIb/IIIa inhibitor administration. However, glycoprotein IIb/IIIa inhibitor use resulted in substantially higher bleeding rates, regardless of whether the patient was randomized to cangrelor or to clopidogrel.
Thus, in general, cangrelor and glycoprotein IIb/IIIa inhibitors should not routinely be combined. If an operator wishes to use a potent intravenous antiplatelet during PCI, cangrelor is similarly efficacious as glycoprotein IIb/IIIa inhibitors, but with less bleeding risk.
MedicalResearch.com: What should readers take away from your report?
Response: Cangrelor is a relatively new option for patients undergoing PCI. It is very effective in reducing peri-procedural complications during PCI, such as stent thrombosis. It has a short half-life which helps reduce the risk of severe bleeding compared with other potent intravenous antiplatelet therapies.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: More data regarding use of cangrelor in PCI patients not included in the CHAMPION clinical trials would be useful.
MedicalResearch.com: Is there anything else you would like to add?
Response: Research funding from The Medicines Company for my role as co-chair of the CHAMPION trials.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Cangrelor With and Without Glycoprotein IIb/IIIa Inhibitors in Patients Undergoing Percutaneous Coronary Intervention
Muthiah Vaduganathan et al
Published By: Journal of the American College of Cardiology
Volume 69, Issue 2,
Published online January 9, 2017.
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