Clinical use of cangrelor : nationwide experience from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)
Grimfjärd, Per ; Lagerqvist, Bo ; Erlinge, David LU
; Varenhorst, Christoph
and James, Stefan
(2019)
In European Heart Journal Cardiovascular Pharmacotherapy
5(3).
p.151-157
- Abstract
AIMS: This nationwide study aimed to analyse the first 2 years of routine clinical use of cangrelor in all Swedish patients undergoing percutaneous coronary intervention (PCI). METHODS AND RESULTS: This observational Swedish Coronary Angiography and Angioplasty Registry (SCAAR) study identified 915 cangrelor-treated patients. As 899 were ST-segment elevation myocardial infarction (STEMI)-patients undergoing primary PCI, we decided to exclude all non-STEMI patients (n = 16) from the following analysis. We then identified all primary PCI patients, January 2016 to January 2018 (n = 10 816). Excluding hospitals without cangrelor use, tailoring time frames from first cangrelor use per hospital, patients treated with cangrelor (n = 899) were... (More)
AIMS: This nationwide study aimed to analyse the first 2 years of routine clinical use of cangrelor in all Swedish patients undergoing percutaneous coronary intervention (PCI). METHODS AND RESULTS: This observational Swedish Coronary Angiography and Angioplasty Registry (SCAAR) study identified 915 cangrelor-treated patients. As 899 were ST-segment elevation myocardial infarction (STEMI)-patients undergoing primary PCI, we decided to exclude all non-STEMI patients (n = 16) from the following analysis. We then identified all primary PCI patients, January 2016 to January 2018 (n = 10 816). Excluding hospitals without cangrelor use, tailoring time frames from first cangrelor use per hospital, patients treated with cangrelor (n = 899) were compared with those without cangrelor treatment (n = 4614). A separate analysis was performed for cardiac arrest STEMI patients (n = 273). Cangrelor-use in primary PCI varied greatly between hospitals (4-36%, mean 16%). At variance with randomized trials, cangrelor was used nearly exclusively in STEMI, often with cardiac arrest (19%). Cangrelor was combined with ticagrelor in two-thirds of patients, among which >50% was prehospital. Cangrelor was used more frequently in high-risk patients: left main PCI, thrombus aspiration, and cardiac arrest. Despite cangrelor being used in more high-risk patients, crude definite stent thrombosis rates at 30 days were low and similar in cangrelor (0.7%) and non-cangrelor treated patients (0.8%). CONCLUSION: Cangrelor was used nearly exclusively in primary PCI STEMI patients, predominantly with ticagrelor. Despite being used in very high-risk patients, often with cardiac arrest, cangrelor treatment was associated with low stent thrombosis rates.
(Less)
- author
- Grimfjärd, Per
; Lagerqvist, Bo
; Erlinge, David
LU
; Varenhorst, Christoph
and James, Stefan
- organization
- publishing date
- 2019-07
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cangrelor, Cardiac arrest, Primary PCI, STEMI
- in
- European Heart Journal Cardiovascular Pharmacotherapy
- volume
- 5
- issue
- 3
- pages
- 7 pages
- publisher
- Oxford University Press
- external identifiers
-
- pmid:30698669
- scopus:85068377764
- ISSN
- 2055-6837
- DOI
- 10.1093/ehjcvp/pvz002
- language
- English
- LU publication?
- yes
- id
- 3b5e4093-7845-463e-88e3-7b518d87527d
- date added to LUP
- 2019-07-16 15:58:13
- date last changed
- 2024-04-02 14:37:27
@article{3b5e4093-7845-463e-88e3-7b518d87527d,
abstract = {{<p>AIMS: This nationwide study aimed to analyse the first 2 years of routine clinical use of cangrelor in all Swedish patients undergoing percutaneous coronary intervention (PCI). METHODS AND RESULTS: This observational Swedish Coronary Angiography and Angioplasty Registry (SCAAR) study identified 915 cangrelor-treated patients. As 899 were ST-segment elevation myocardial infarction (STEMI)-patients undergoing primary PCI, we decided to exclude all non-STEMI patients (n = 16) from the following analysis. We then identified all primary PCI patients, January 2016 to January 2018 (n = 10 816). Excluding hospitals without cangrelor use, tailoring time frames from first cangrelor use per hospital, patients treated with cangrelor (n = 899) were compared with those without cangrelor treatment (n = 4614). A separate analysis was performed for cardiac arrest STEMI patients (n = 273). Cangrelor-use in primary PCI varied greatly between hospitals (4-36%, mean 16%). At variance with randomized trials, cangrelor was used nearly exclusively in STEMI, often with cardiac arrest (19%). Cangrelor was combined with ticagrelor in two-thirds of patients, among which >50% was prehospital. Cangrelor was used more frequently in high-risk patients: left main PCI, thrombus aspiration, and cardiac arrest. Despite cangrelor being used in more high-risk patients, crude definite stent thrombosis rates at 30 days were low and similar in cangrelor (0.7%) and non-cangrelor treated patients (0.8%). CONCLUSION: Cangrelor was used nearly exclusively in primary PCI STEMI patients, predominantly with ticagrelor. Despite being used in very high-risk patients, often with cardiac arrest, cangrelor treatment was associated with low stent thrombosis rates.</p>}},
author = {{Grimfjärd, Per and Lagerqvist, Bo and Erlinge, David and Varenhorst, Christoph and James, Stefan}},
issn = {{2055-6837}},
keywords = {{Cangrelor; Cardiac arrest; Primary PCI; STEMI}},
language = {{eng}},
number = {{3}},
pages = {{151--157}},
publisher = {{Oxford University Press}},
series = {{European Heart Journal Cardiovascular Pharmacotherapy}},
title = {{Clinical use of cangrelor : nationwide experience from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)}},
url = {{http://dx.doi.org/10.1093/ehjcvp/pvz002}},
doi = {{10.1093/ehjcvp/pvz002}},
volume = {{5}},
year = {{2019}},
}