• Am. J. Cardiol. · Apr 2019

    Effects of Cangrelor as Adjunct Therapy to Percutaneous Coronary Intervention.

    • Alexandre Hideo-Kajita, Toby Rogers, Kyle Buchanan, Micaela Iantorno, Deepakraj Gajanana, Yuichi Ozaki, Kazuhiro Dan, Paul Kolm, Echo Brathwaite, Solomon Beyene, Gebremedhin Melaku, Yael Meirovich, Aaphtaab Dheendsa, Hector M Garcia-Garcia, Rebecca Torguson, and Ron Waksman.
    • Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia.
    • Am. J. Cardiol. 2019 Apr 15; 123 (8): 1228-1238.

    AbstractPercutaneous coronary intervention (PCI) in patients with angiographic evidence of intracoronary thrombus is associated with in-hospital and 30-day adverse clinical outcomes. Cangrelor, a direct, rapid-onset acting intravenous P2Y12 receptor inhibitor, has been proved to be effective by reducing peri-PCI ischemic complications in subjects who underwent PCI. This study aimed to assess the angiographic and in-hospital clinical outcomes in all-comer patients receiving cangrelor immediately before PCI at a tertiary care center. The study analyzed consecutive unselected subjects treated with cangrelor at the time the decision was made to proceed with PCI. At the end of the procedure, all patients were transitioned to oral antiplatelet therapy. The target lesion angiographic assessment of Thrombolysis in myocardial infarction flow grade (TIMI-Flow), TIMI-thrombus grade (TIMI-Thrombus), myocardial blush grade, and TIMI-myocardial perfusion grade (TMPG) was performed before and post-PCI. Clinical events were recorded during the procedure and at discharge. In total, 223 patients (244 lesions) were included in the analysis (106, 97, and 20 patientswith TIMI-Flow 0/1, TIMI-Flow 2/3, and cardiogenic shock, respectively). The overall mean age was 63 ± 12 years, 70% men and 38% with diabetes mellitus. Acute myocardial infarction was the main presentation (72%). The use of cangrelor improved TIMI-Flow, MGB, TMPG, and TIMI-Thrombus in patients with initial TIMI-Flow 0 to 2. Major bleeding rate was 2.0%. In conclusion, cangrelor was effective and safe in restoring TIMI-Flow 3, reducing thrombus burden and improving myocardial blush grade and TMPG when administered to unselected subjects who underwent PCI. Therefore, cangrelor should be considered in patients presenting with intracoronary thrombus before intervention.Copyright © 2019. Published by Elsevier Inc.

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