Author + information
- Matthew Cavendera,b,
- Robert Harringtona,b,
- Gregg Stonea,b,
- Efthymios Deliargyrisa,b,
- Philippe Stega,b,
- C. Michael Gibsona,b,
- Christian Hamma,b,
- Matthew Pricea,b,
- Jayne Pratsa,b,
- Kenneth Mahaffeya,b,
- Harvey Whitea,b and
- Deepak Bhatta,b
Background: Cangrelor reduced death, MI(SCAI definition), ischemia-driven revascularization (IDR), or stent thrombosis (ARC-ST) at 48 hours in patients undergoing PCI in the CHAMPION PHOENIX trial. We sought to determine the timing of events to characterize the effects of cangrelor.
Methods: A total of 11,145 patients undergoing PCI were randomized at the time of angiography to either cangrelor or clopidogrel. Events that occurred as part of the composite endpoint of death, MI(SCAI definition), IDR, or ARC-ST were grouped in 2-hour windows from randomization based on investigator-reported times.
Results: Of the 270 ischemic events that occurred in the first 48 hours, 63.3% (n=171) occurred during the first two hours. The majority were MI (SCAI) (44%, n=120) and 7% (n=19) were ARC-ST, 7% (n=18) IDR, 5% (n=14) death. In the period from 2-6 hours compared with the first 2 peri-procedural hours, overall events decreased by 73%. In first 2 hours, cangrelor significantly decreased the events of the composite endpoint when compared to clopidogrel (56 vs. 115, RR 0.47, 95% CI 0.35-0.67, p<0.001). There was no excess of events (26 vs. 21) in the cangrelor arm during the 2-6 hours post-PCI transition period to oral clopidogrel when compared to patients given clopidogrel at the time of PCI.
Conclusions: In the CHAMPION PHOENIX trial, the majority of events were MIs that occurred in the first two hours after the start of PCI. Treatment with cangrelor, when compared to clopidogrel, reduced these early ischemic events.
Moderated Poster Contributions
Acute and Stable Ischemic Heart Disease Moderated Poster Theater, Poster Hall, Hall C
Saturday, March 18, 2017, 1:30 p.m.-1:40 p.m.
Session Title: Anti-Platelet Therapies: Always a Sticky Topic
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1227M-11
- 2017 American College of Cardiology Foundation