Feasibility and safety of cangrelor in patients with suboptimal P2Y(12) inhibition undergoing percutaneous coronary intervention: rationale of the Dutch Cangrelor Registry

A. Selvarajah, A. H. Tavenier, W. L. Bor, Alfons J. H. M. Houben, S. Rasoul, E. Kaplan, K. Teeuwen, S. H. Hofma, E. Lipsic, G. Amoroso, M. A. H. van Leeuwen, J. M. ten Berg, A. W. J. van 't Hof, R. S. Hermanides*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background Despite the advances of potent oral P2Y(12) inhibitors, their onset of action is delayed, which might have a negative impact on clinical outcome in patients undergoing percutaneous coronary intervention (PCI). Trials conducted in the United States of America have identified cangrelor as a potent and rapid-acting intravenous P2Y(12) inhibitor, which has the potential of reducing ischemic events in these patients without an increase in the bleeding. As cangrelor is rarely used in The Netherlands, we conducted a nationwide registry to provide an insight into the use of cangrelor in the management of patients with suboptimal platelet inhibition undergoing (primary) PCI (the Dutch Cangrelor Registry). Study design The Cangrelor Registry is a prospective, observational, multicenter, single-arm registry with cangrelor administered pre-PCI in: (1) P2Y(12) naive patients with ad-hoc PCI, (2) patients with STEMI/NSTEMI with suboptimal P2Y(12) inhibition including (3) stable resuscitated/defibrillated patients with out-of-hospital cardiac arrest (OHCA) due to acute ischemia and (4) STEMI/NSTEMI patients with a high thrombotic burden. Primary endpoint is 48 h Net Adverse Clinical Events (NACE), which is a composite endpoint of all-cause death, recurrent myocardial infarction (MI), target vessel revascularization (TVR), stroke, stent thrombosis (ST) and BARC 2-3-5 bleeding. The Dutch Cangrelor Registry will assess the feasibility and safety of cangrelor in patients with suboptimal P2Y(12) inhibition undergoing (primary) PCI in the setting of acute coronary syndrome (ACS) and stable coronary artery disease (CAD) in the Netherlands.

Original languageEnglish
Article number292
Number of pages7
JournalBMC Cardiovascular disorders
Volume21
Issue number1
DOIs
Publication statusPublished - 12 Jun 2021

Keywords

  • Cangrelor
  • P2Y(12) inhibitors
  • Percutaneous coronary intervention
  • Platelet inhibition
  • ELEVATION MYOCARDIAL-INFARCTION
  • PLATELET INHIBITION
  • DISTAL EMBOLIZATION
  • IMPAIRED BIOAVAILABILITY
  • STENT THROMBOSIS
  • CLOPIDOGREL
  • TICAGRELOR
  • THERAPY
  • IMPACT
  • TRANSITION

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