Back to Search
Start Over
Cangrelor reduces the risk of ischemic complications in patients with single-vessel and multi-vessel disease undergoing percutaneous coronary intervention: Insights from the CHAMPION PHOENIX trial.
- Source :
-
American heart journal [Am Heart J] 2017 Jun; Vol. 188, pp. 147-155. Date of Electronic Publication: 2017 Mar 06. - Publication Year :
- 2017
-
Abstract
- Objective: To examine the safety and efficacy of cangrelor in patients with single-vessel disease (SVD) and multi-vessel disease (MVD).<br />Background: Cangrelor, an intravenous, rapidly acting P2Y <subscript>12</subscript> inhibitor, is superior to clopidogrel in reducing ischemic events among patients receiving percutaneous coronary intervention (PCI).<br />Methods: We studied a modified intention to treat population of patients with SVD and MVD from the CHAMPION PHOENIX trial. The primary efficacy outcome was the composite of death, myocardial infarction (MI), ischemia-driven revascularization (IDR), and stent thrombosis (ST) at 48hours. The key safety outcome was non-coronary artery bypass grafting GUSTO severe bleeding at 48hours.<br />Results: Among 10,921 patients, 5,220 (48%) had SVD and 5,701 (52%) had MVD. MVD patients were older and more often had diabetes, hyperlipidemia, hypertension, prior stroke, and prior MI. After adjustment, MVD patients had similar rates of 48-hour death/MI/IDR/ST (6.3% vs 4.2%, adjusted odds ratio [OR] 1.6 [95% CI 0.42-6.06]) and GUSTO severe bleeding (0.1% vs 0.2%, P=.67) compared with SVD patients. Consistent with overall trial findings, cangrelor use reduced ischemic complications in patients with both SVD (3.9% vs 4.5%; OR 0.86, 95% CI 0.65-1.12) and MVD (5.5% vs 7.2%; OR 0.74, 95% CI 0.6-0.92, P-interaction=.43). GUSTO severe bleeding outcomes were not significantly increased with cangrelor or clopidogrel in either SVD or MVD patients.<br />Conclusion: In the CHAMPION PHOENIX trial, MVD and SVD patients had similar ischemic outcomes at 48hours and 30days. Cangrelor consistently reduced ischemic complications in both SVD and MVD patients without a significant increase in GUSTO severe bleeding. CLINICAL PERSPECTIVES.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Subjects :
- Adenosine Monophosphate administration & dosage
Administration, Oral
Aged
Cause of Death trends
Clopidogrel
Coronary Angiography
Coronary Artery Disease diagnosis
Dose-Response Relationship, Drug
Double-Blind Method
Female
Follow-Up Studies
Global Health
Humans
Incidence
Infusions, Intravenous
Male
Middle Aged
Myocardial Infarction epidemiology
Postoperative Complications epidemiology
Purinergic P2Y Receptor Antagonists administration & dosage
Survival Rate trends
Ticlopidine administration & dosage
Ticlopidine analogs & derivatives
Time Factors
Adenosine Monophosphate analogs & derivatives
Coronary Artery Disease therapy
Myocardial Infarction prevention & control
Percutaneous Coronary Intervention
Postoperative Complications prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6744
- Volume :
- 188
- Database :
- MEDLINE
- Journal :
- American heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 28577670
- Full Text :
- https://doi.org/10.1016/j.ahj.2017.02.031