Abstract 18632: Variation in Patient Profiles and Outcomes in US and non-US Subgroups of the Cangrelor versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition (CHAMPION) PHOENIX Trial
Objectives: To describe the clinical profiles, safety and efficacy endpoints, and response to cangrelor in US and non-US subgroups.
Background: CHAMPION PHOENIX demonstrated superiority of cangrelor in reducing ischemic events at 48 hours in patients undergoing percutaneous coronary intervention (PCI) compared with clopidogrel.
Methods: We analyzed all patients included in the modified intention-to-treat analysis in US (n=4,097; 37.4%) and non-US subgroups (n=6,845; 62.6%).
Results: The US cohort was older and had higher rates of cardiovascular risk factors and prior cardiovascular procedures. US patients more frequently underwent PCI for stable angina (72.4% vs. 46.4%). Utilization of clopidogrel loading doses of 600mg and bivalirudin was also higher in US vs. non-US participants. At 48 hours, rates of the primary composite endpoint were lower in the cangrelor arm compared with the clopidogrel arm in US (4.5% vs. 6.4%; OR 0.71 [0.54-0.92]) and in non-US patients (4.8% vs. 5.6%; OR 0.85 [0.69-1.05]); interaction P=0.26 (Table). Similarly, rates of the key secondary endpoint, stent thrombosis, were reduced by cangrelor in both regions. Rates of GUSTO (Global Use of Strategies to Open Occluded Arteries)-defined severe bleeding were low and not significantly increased by cangrelor in either region.
Conclusions: Despite broad differences in clinical profiles and indications for PCI by region in a large global cardiovascular clinical trial, cangrelor consistently reduced rates of ischemic endpoints compared with clopidogrel without an excess in severe bleeding in both US and non-US subgroups.
Author Disclosures: The Disclosure Block has exceeded its maximum limit. Please call Tech support at (217) 398-1792 for more information.
- © 2015 by American Heart Association, Inc.