Author + information
- Muthiah Vaduganathana,b,
- Robert Harringtona,b,
- Gregg Stonea,b,
- Philippe Stega,b,
- C. Michael Gibsona,b,
- Christian Hamma,b,
- Matthew Pricea,b,
- Efthymios Deliargyrisa,b,
- Jayne Pratsa,b,
- Kenneth Mahaffeya,b,
- Harvey Whitea,b and
- Deepak Bhatta,b
Background: Cangrelor is approved for use during percutaneous coronary intervention (PCI) and is administered with different intravenous anticoagulants.
Methods: We examined the efficacy and safety of cangrelor in the subgroup of patients who received unfractionated heparin for PCI in the mITT population of the randomized CHAMPION PHOENIX trial (cangrelor vs. clopidogrel; n=10,939). The primary efficacy endpoint was the composite of death, myocardial infarction, ischemia-driven revascularization, or stent thrombosis (ST) at 48h. The key secondary efficacy endpoint was ST.
Results: Heparin was used in 69.2% (7,566/10,939) of patients. PCI was performed for stable angina (55.6%), NSTE-ACS (26.6%), or STEMI (17.8%). In the unfractionated heparin subgroup, cangrelor reduced the primary composite efficacy endpoint at 48h compared to clopidogrel (4.8% vs. 5.9%; OR 0.80 [0.65-0.98]; P=0.03) [Figure]. Cangrelor consistently reduced ST at 2h (0.7% vs. 1.3%; OR 0.56 [0.35-0.90]; P=0.01) and 48h (0.9% vs. 1.4%; OR 0.70 [0.45-1.07]; P=0.10). There was no difference in GUSTO severe/life-threatening bleeding (0.1% vs. 0.1%; OR 1.24 [0.33-4.61]; P=0.75) or blood transfusion requirement at 48h (0.4% vs. 0.2%; OR 1.87 [0.83-4.21]; P=0.12). Results were consistent in stable angina, NSTE-ACS, and STEMI.
Conclusions: Cangrelor reduces early ischemic periprocedural complications without increasing severe bleeding compared with clopidogrel in patients undergoing PCI with unfractionated heparin.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Optimizing the Care of ACS Patients
Abstract Category: 15. Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology
Presentation Number: 1284-149
- 2017 American College of Cardiology Foundation