Key result
Peri-procedural cangrelor during PCI linked to 18% 48-hour mortality without major bleeding.
Why the study?
Cangrelor is increasingly used during PCI for rapid, reversible platelet inhibition in emergencies, but its use and outcomes required evaluation in a non-surgical district general hospital setting.
What are the 48-hour clinical outcomes of peri-procedural cangrelor use in patients undergoing PCI at a district general hospital?
Observational (n=93)
No
What are the 48-hour clinical outcomes of peri-procedural cangrelor use in patients undergoing PCI at a district general hospital?
In a real-world UK district general hospital setting, peri-procedural cangrelor use during PCI was associated with no major bleeding and a 1.1% rate of cardiovascular events at 48 hours, though all-cause mortality was 18%, likely reflecting a high-risk patient population.
Low CV event rate supports cangrelor safety; extends RCT evidence for short-term use in high-mortality settings.
Background/Objectives: Cangrelor, an intravenous P2Y12 inhibitor, is increasingly used during percutaneous coronary intervention (PCI) for rapid and reversible platelet inhibition in patients unable to take oral antiplatelet agents, particularly in emergencies such as ST-elevation myocardial infarction (STEMI), cardiac arrest, or cardiogenic shock. This single-centre study evaluates cangrelor and outcomes in a non-surgical centre. Methods: Between June 2017 and December 2021, all the patients for whom cangrelor was used at a district general hospital (DGH) in the UK were included in this study. Data collection included baseline characteristics, admission, procedural details, and patient outcomes. The primary outcome was a composite of all-cause mortality, bleeding, and cardiovascular events, including myocardial infarction, stent thrombosis, and stroke, within 48 h. Secondary outcomes included predictors of the composite outcome at 48 h. Results: During the study period, cangrelor was administered peri-procedurally to 93 patients. Males comprised 85% of the patients; the mean age was 65.5 ± 10.6 years. A total of 1 patient (1.1%) had a cardiovascular event within 48 h of cangrelor administration, whereas all-cause mortality occurred in 17 patients (18%) within 48 h. No major bleeding events were noted at 48 h following cangrelor administration. Regression analysis did not find predictors of composite outcomes at 48 h. Conclusions: Cangrelor offers a potential alternative to oral P2Y12 inhibitors in specific high-risk scenarios. Further research is needed to validate its role in broader populations.
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Antoun et al. (2025) conducted an observational in Percutaneous coronary intervention (n=93). Cangrelor was evaluated on Composite of all-cause mortality, bleeding, and cardiovascular events within 48 h. Among 93 patients receiving peri-procedural cangrelor during PCI, 48-hour all-cause mortality was 18%, cardiovascular events occurred in 1.1%, and no major bleeding events were observed.
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