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Cangrelor During Percutaneous Coronary Intervention in Patients With Cardiogenic Shock or Cardiac Arrest

Emilsson, Oskar Love LU orcid ; Mohammad, Moman A. LU orcid ; Grimfjärd, Per ; Persson, Jonas ; Santos-Pardo, Irene ; Erlinge, David LU orcid and Koul, Sasha LU (2025) In JACC: Cardiovascular Interventions 18(7). p.853-862
Abstract

Background: Little is known regarding treatment with cangrelor during percutaneous coronary intervention (PCI) in patients with myocardial infarction complicated by cardiogenic shock or cardiac arrest. Objectives: The aim of this study was to investigate the effects of such cangrelor treatment during PCI in patients with myocardial infarction complicated by cardiogenic shock or cardiac arrest. Methods: The study population included patients undergoing PCI (2016-2022) for myocardial infarction with cardiogenic shock or cardiac arrest from SCAAR (Swedish Coronary Angiography and Angioplasty Registry). Propensity score (PS)–matched groups were compared regarding major adverse cardiovascular events (MACE) within 30 days, in-hospital major... (More)

Background: Little is known regarding treatment with cangrelor during percutaneous coronary intervention (PCI) in patients with myocardial infarction complicated by cardiogenic shock or cardiac arrest. Objectives: The aim of this study was to investigate the effects of such cangrelor treatment during PCI in patients with myocardial infarction complicated by cardiogenic shock or cardiac arrest. Methods: The study population included patients undergoing PCI (2016-2022) for myocardial infarction with cardiogenic shock or cardiac arrest from SCAAR (Swedish Coronary Angiography and Angioplasty Registry). Propensity score (PS)–matched groups were compared regarding major adverse cardiovascular events (MACE) within 30 days, in-hospital major bleeding, and all-cause mortality within 30 days. Results: A total of 3,014 patients with cardiogenic shock or cardiac arrest were included, 1,011 receiving and 2,003 not receiving cangrelor. In the PS-matched analysis regarding patients with cardiogenic shock (n = 994), the risk ratio (with vs without cangrelor) was 0.82 (95% CI: 0.71-0.94) for MACE, with an absolute risk reduction of 8.9 percentage points (95% CI: 2.7-15 percentage points) (number needed to treat = 12); 1.60 (95% CI: 0.93-2.76) for major bleeding; and 0.81 (95% CI: 0.70-0.94) for mortality, with an absolute risk reduction of 8.9 percentage points (95% CI: 2.7-15 percentage points) (number needed to treat = 12). In the PS-matched analysis regarding patients with cardiac arrest (n = 1,138), the risk ratio was 1.01 (95% CI: 0.87-1.18) for MACE; 2.26 (95% CI: 1.25-4.11) for major bleeding, with an absolute risk increase of 3.5 percentage points (95% CI: 1.0-5.7 percentage points); and 0.97 (95% CI: 0.83-1.13) for all-cause mortality. Conclusions: For patients with cardiogenic shock, administration of cangrelor during PCI was associated with a lower risk for both MACE and all-cause mortality. For patients with cardiac arrest, no such benefit was observed, and a higher risk for major bleeding was found.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cangrelor, cardiac arrest, cardiogenic shock, myocardial infarction, percutaneous coronary intervention
in
JACC: Cardiovascular Interventions
volume
18
issue
7
pages
10 pages
publisher
Elsevier
external identifiers
  • pmid:40240083
  • scopus:105001853050
ISSN
1936-8798
DOI
10.1016/j.jcin.2025.01.451
language
English
LU publication?
yes
id
0f8889b2-a6c0-4ccc-989c-41aa92ee574a
date added to LUP
2025-08-08 12:13:30
date last changed
2025-08-08 15:51:14
@article{0f8889b2-a6c0-4ccc-989c-41aa92ee574a,
  abstract     = {{<p>Background: Little is known regarding treatment with cangrelor during percutaneous coronary intervention (PCI) in patients with myocardial infarction complicated by cardiogenic shock or cardiac arrest. Objectives: The aim of this study was to investigate the effects of such cangrelor treatment during PCI in patients with myocardial infarction complicated by cardiogenic shock or cardiac arrest. Methods: The study population included patients undergoing PCI (2016-2022) for myocardial infarction with cardiogenic shock or cardiac arrest from SCAAR (Swedish Coronary Angiography and Angioplasty Registry). Propensity score (PS)–matched groups were compared regarding major adverse cardiovascular events (MACE) within 30 days, in-hospital major bleeding, and all-cause mortality within 30 days. Results: A total of 3,014 patients with cardiogenic shock or cardiac arrest were included, 1,011 receiving and 2,003 not receiving cangrelor. In the PS-matched analysis regarding patients with cardiogenic shock (n = 994), the risk ratio (with vs without cangrelor) was 0.82 (95% CI: 0.71-0.94) for MACE, with an absolute risk reduction of 8.9 percentage points (95% CI: 2.7-15 percentage points) (number needed to treat = 12); 1.60 (95% CI: 0.93-2.76) for major bleeding; and 0.81 (95% CI: 0.70-0.94) for mortality, with an absolute risk reduction of 8.9 percentage points (95% CI: 2.7-15 percentage points) (number needed to treat = 12). In the PS-matched analysis regarding patients with cardiac arrest (n = 1,138), the risk ratio was 1.01 (95% CI: 0.87-1.18) for MACE; 2.26 (95% CI: 1.25-4.11) for major bleeding, with an absolute risk increase of 3.5 percentage points (95% CI: 1.0-5.7 percentage points); and 0.97 (95% CI: 0.83-1.13) for all-cause mortality. Conclusions: For patients with cardiogenic shock, administration of cangrelor during PCI was associated with a lower risk for both MACE and all-cause mortality. For patients with cardiac arrest, no such benefit was observed, and a higher risk for major bleeding was found.</p>}},
  author       = {{Emilsson, Oskar Love and Mohammad, Moman A. and Grimfjärd, Per and Persson, Jonas and Santos-Pardo, Irene and Erlinge, David and Koul, Sasha}},
  issn         = {{1936-8798}},
  keywords     = {{cangrelor; cardiac arrest; cardiogenic shock; myocardial infarction; percutaneous coronary intervention}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{853--862}},
  publisher    = {{Elsevier}},
  series       = {{JACC: Cardiovascular Interventions}},
  title        = {{Cangrelor During Percutaneous Coronary Intervention in Patients With Cardiogenic Shock or Cardiac Arrest}},
  url          = {{http://dx.doi.org/10.1016/j.jcin.2025.01.451}},
  doi          = {{10.1016/j.jcin.2025.01.451}},
  volume       = {{18}},
  year         = {{2025}},
}