Abstract 12336: Cangrelor Decreases Ischemia Driven Revascularization in Patients Undergoing Percutaneous Coronary Intervention: Evidence From a Meta-analysis of Randomized Trials
Cangrelor decreases ischemia driver revascularization in Patients Undergoing percutaneous coronary intervention: Evidence from a meta-analysis of randomized trials
Introduction: Cangrelor is a new parenteral adenosine diphosphate P2Y12 receptor inhibitor with rapid, profound and reversible inhibition of platelet activity. The aim of this meta-analysis is to evaluate efficacy and safety of this new agent in patients undergoing percutaneous coronary intervention (PCI).
Methods: We searched PubMed, Cochrane Library, EMBASE, Web of Science and CINAHL databases from the inception through April 2013. Randomized controlled trials (RCTs) comparing cangrelor with control (clopidogrel/placebo) were selected. We used the random-effects models to calculate the risk ratio. Primary efficacy outcome was ischemia-driven revascularization, and primary safety outcome was TIMI major (Thrombolysis in Myocardial infarction criteria) bleeding at 48 hours.
Results: Three RCTs included a total of 25,107 participants. The effects of Cangrelor were not different against comparators for MI (Risk ratio [RR] 0.94, 95% confidence interval [CI] 0.78 to 1.13) and all-cause mortality ( RR 0.72, 95% CI 0.36 to 1.43) . However, cangrelor significantly reduced the risk of ischemia-driven revascularization (RR 0.72, 95% CI 0.52 to 0.98), Stent thrombosis (RR 0.60, 95% CI 0.44 to 0.82) and Q wave MI (RR 0.53, 95% CI 0.30 to 0.92) without causing an increase in severe or life-threatening GUSTO bleeding (Global utilization of streptokinase and tissue plasminogen activator for occluded coronary arteries criteria) or TIMI major bleeding. Separate analysis against only clopidogrel also showed similar findings except Q wave MI outcome.
Conclusion: Use of cangrelor during PCI might reduce the risk of ischemia-driven revascularization and stent thrombosis, without causing increase in major bleeding.
- © 2013 by American Heart Association, Inc.