Efficacy and safety of cangrelor for patients with coronary artery disease: a meta-analysis of four randomized trials.

BACKGROUND

The efficacy and safety of new intravenous P2Y12 inhibitor (cangrelor) for patients with coronary artery disease (CAD) remain unclear.

METHODS AND RESULTS

Trials were identified in PubMed, Web of Science, Embase, and Cochrane Database searches. We included four randomized, placebo-controlled reports in the meta-analysis. The database consisted of 36, 081 patients on cangrelor compared with clopidogrel or placebo. Major adverse cardiac events (MACE) were defined as the primary efficacy endpoint and major or severe bleeding at 48 hours was defined as the primary safety endpoint. Cangrelor significantly decreased risk of MACE (OR: 0.87, P = 0.002) and stent thrombosis (OR: 0.53, P < 0.001). However, at the same time, an increase in TIMI minor bleeding (OR: 1.49, P = 0.04) and in GUSTO moderate bleeding (OR: 1.43, P = 0.04) were observed by cangrelor.

CONCLUSIONS

Intravenous administration of cangrelor is benefit to reduce risk of MACE and stent thrombosis in patients with CAD excepting for increased minor bleeding events.