Author + information
- Moman Aladdin Mohammad,
- Pontus Andell,
- Matthias Götberg,
- Fredrik Scherstén,
- Sasha Koul and
- David Erlinge
Cangrelor is a rapid onset and offset P2Y12-inhibitor with a recently approved indication for patients treated with percutaneous coronary intervention (PCI) without adequate pretreatment with P2Y12-inhibitors. A direct pharmacodynamic evaluation has not yet been reported in real-world ST-segment elevation myocardial infarction (STEMI) patients.
In a prospective series 26 STEMI patients undergoing primary PCI with less than1 hour pretreatment with a 180 mg loading dose of Ticagrelor were included. P2Y12 reaction units (PRU) were assessed with VerifyNow P2Y12 (max reported lab-value was “more than 230”), at beginning of PCI before Cangrelor-infusion, 15 min after start of infusion and 30 min after end of the 2h infusion. All patients were treated with ticagrelor 180 mg pre-hospital or at start of PCI.
P2Y12 inhibition was weak at start of PCI (230.0 PRU; 95% CI 215.7-230). After 15 min of Cangrelor-infusion, the P2Y12-inhibition was markedly improved (67.0 PRU; 50.9-107.9; P=0.0001). During infusion no patient had high on-treatment platelet reactivity (HPR; more than 225 PRU). At 30 min after end of infusion, PRU was increased but still within therapeutic range (115.5 PRU; 76.3-173.0; P=0.001) and 25% of the patients with HPR.
In unselected real world patients with STEMI undergoing PCI with Ticagrelor given pre-hospital or during PCI, Cangrelor gave rapid and marked P2Y12-inhibition with no patients with HPR during infusion.
Poster Area, South Hall A1
Saturday, April 02, 2016, 3:45 p.m.-4:30 p.m.
Session Title: Acute Coronary Syndromes: Managing Dilemmas in Antithrombotic Therapy
Abstract Category: 15. Acute Coronary Syndromes: Therapy
Presentation Number: 1133-022
- 2016 American College of Cardiology Foundation