NEW ORLEANS, LA—Cangrelor, an intravenous potent, rapid-acting P2Y12 inhibitor, reduces the risk of early ischemic events compared with clopidogrel in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI), investigators reported during the American College of Cardiology’s 60th Annual Scientific Sessions.
Study investigators Harvey D. White, MD from Brigham and Women’s Hospital & VA Boston Healthcare System, Boston, and colleagues performed an analysis of the CHAMPION PLATFORM and the PCI studies, parallel double-blind Phase 3 trials comparing cangrelor with clopidogrel in PCI patients (n=13,049). The primary endpoint for both studies was death, myocardial infarction (MI), or ischemia-driven revascularization (IDR) (including stent thrombosis) at 48 hours. The median age was 62.5 years, while females and diabetics made up 28% and 31.7% of the study population, respectively
Data from both studies were pooled as they had similar inclusion/exclusion criteria. STEMI patients (predefined safety population) were excluded as recurrent MI could not be discriminated from the index MI. The investigators applied the Universal Definition of MI (Type 4) to the Clinical Events Committee adjudicated MI. MI was defined as an elevation of CK-MB >3x ULN if the baseline was stable/falling, or as new Q-waves. MI re-evaluation was blinded to treatment allocation. See Tables.
Study results demonstrated that major (TIMI or GUSTO) bleeding and transfusions were not increased with cangrelor and that using the Universal Definition of MI, cangrelor was associated with a significant reduction in early ischemic events when compared with clopidogrel in PCI patients.