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- Title
Cangrelor Use in Routine Practice: A Two-Center Experience.
- Authors
van der Sangen, Niels M. R.; Cheung, Ho Yee; Verouden, Niels J. W.; Appelman, Yolande; Beijk, Marcel A. M.; Claessen, Bimmer E. P. M.; Delewi, Ronak; Knaapen, Paul; Lemkes, Jorrit S.; Nap, Alexander; Vis, M. Marije; Kikkert, Wouter J.; Henriques, José P. S.
- Abstract
Cangrelor is the first and only intravenous P2Y12-inhibitor and is indicated when (timely) administration of an oral P2Y12 inhibitor is not feasible in patients undergoing percutaneous coronary intervention (PCI). Our study evaluated the first years of cangrelor use in two Dutch tertiary care centers. Cangrelor-treated patients were identified using a data-mining algorithm. The cumulative incidences of all-cause death, myocardial infarction, definite stent thrombosis and major bleeding at 48 h and 30 days were assessed using Kaplan–Meier estimates. Predictors of 30-day mortality were identified using uni- and multivariable Cox regression models. Between March 2015 and April 2021, 146 patients (median age 63.7 years, 75.3% men) were treated with cangrelor. Cangrelor was primarily used in ST-segment elevation myocardial infarction (STEMI) patients (84.2%). Approximately half required cardiopulmonary resuscitation (54.8%) or mechanical ventilation (48.6%). The cumulative incidence of all-cause death was 11.0% and 25.3% at 48 h and 30 days, respectively. Two cases (1.7%) of definite stent thrombosis, both resulting in myocardial infarction, occurred within 30 days, but after 48 h. No other cases of recurrent myocardial infarction transpired within 30 days. Major bleeding occurred in 5.6% and 12.5% of patients within 48 h and 30 days, respectively. Cardiac arrest at presentation was an independent predictor of 30-day mortality (adjusted hazard ratio 5.20, 95%-CI: 2.10–12.9, p < 0.01). Conclusively, cangrelor was used almost exclusively in STEMI patients undergoing PCI. Even though cangrelor was used in high-risk patients, its use was associated with a low rate of stent thrombosis.
- Subjects
PERCUTANEOUS coronary intervention; MYOCARDIAL infarction; CARDIOPULMONARY resuscitation; CARDIAC arrest; HEMORRHAGE; ARTIFICIAL respiration
- Publication
Journal of Clinical Medicine, 2021, Vol 10, Issue 13, p2829
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm10132829