Division of Cardiology Department of Cardiosciences Azienda Ospedaliera San Camillo-Forlanini Roma Italy.
FACT (French Alliance for Cardiovascular Trials) and INSERM U-1148 AP-HPHôpital BichatUniversité de Paris France.
J Am Heart Assoc. 2021 Jul 6;10(13):e022125. doi: 10.1161/JAHA.121.022125. Epub 2021 Jul 2.
Cangrelor is the only currently available intravenous platelet P2Y receptor inhibitor. It is characterized by potent, predictable, and rapidly reversible antiplatelet effects. Cangrelor has been tested in the large CHAMPION (Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition) program, where it was compared with different clopidogrel regimens, and it is currently indicated for use in patients with coronary artery disease undergoing percutaneous coronary intervention. However, the uptake of cangrelor use varies across the globe and may also include patients with profiles different from those enrolled in the registration trials. These observations underscore the need to fully examine the safety and efficacy of cangrelor in postregistration studies. There are several ongoing and planned studies evaluating the use of cangrelor in real-world practice which will provide important insights to this extent. The current article provides a review on the pharmacology, clinical studies, contemporary use of cangrelor in real-world practice, a description of ongoing studies, and futuristic insights on potential strategies on how to improve outcomes of patients undergoing percutaneous coronary intervention.
坎格雷洛是唯一目前可用于静脉内血小板 P2Y 受体抑制剂。它具有强大、可预测和快速可逆的抗血小板作用。坎格雷洛已经在大型 CHAMPION(坎格雷洛与标准治疗以实现最佳血小板抑制管理)研究计划中进行了测试,与不同的氯吡格雷方案进行了比较,目前被指示用于接受经皮冠状动脉介入治疗的冠心病患者。然而,坎格雷洛的使用在全球范围内存在差异,也可能包括与注册试验中招募的患者 profile 不同的患者。这些观察结果强调了在注册后研究中充分检查坎格雷洛的安全性和疗效的必要性。目前有几项正在进行和计划中的研究评估坎格雷洛在真实世界实践中的使用,这将在一定程度上提供重要的见解。本文综述了坎格雷洛的药理学、临床研究、在真实世界实践中的当代应用、正在进行的研究描述以及对如何改善接受经皮冠状动脉介入治疗的患者预后的潜在策略的未来展望。