Key result
Cangrelor use during PCI is linked to a ~6% bleeding rate within 48 hours.
Why the study?
Limited real-world data are available for cangrelor usage in high-risk patients undergoing PCI.
Is the real-world use of cangrelor safe and effective in high-risk patients undergoing PCI?
Observational (n=411)
Yes
Is the real-world use of cangrelor safe and effective in high-risk patients undergoing PCI?
Real-world use of cangrelor in high-risk PCI patients in Türkiye demonstrates an acceptable safety profile with low rates of major bleeding.
Supports cangrelor safety in real-world high-risk PCI; extends observational data but leaves open randomized confirmation of net benefit.
Background/Objectives: The only intravenous P2Y12 inhibitor used in the management of acute and chronic coronary syndromes is cangrelor. Previous studies have demonstrated the efficacy of cangrelor. However, limited real-world data are available for cangrelor usage. This study aimed to investigate the use of cangrelor in large-volume percutaneous coronary intervention (PCI) centers in Türkiye, and examine the indications, patient characteristics, bleeding, and ischemic events. The efficacy and safety of cangrelor in this high-risk group were evaluated. Methods: This study was conducted retrospectively in 14 high-volume centers in Türkiye with extensive cangrelor experience. Cangrelor indications, patient clinical characteristics, periprocedural and postprocedural treatments, in-hospital and follow-up bleeding, ischemic events, and mortality were analyzed. Results: This study recruited 411 patients (mean age: 63.8 ± 12.7 years; 76% male). The most common conditions in which cangrelor is used in Türkiye are cardiogenic shock, intubation and nausea/vomiting, where P2Y12 cannot be used adequately due to impaired oral intake. The incidence rate of any bleeding within 48 h was 6.4% (n = 26), with major bleeding accounting for 1.7% of all cases (n = 7). The bleeding rates were similar between patients aged <75 years and those aged ≥75 years (6.0% vs. 8.8%, p = 0.326), as well as between patients with chronic kidney disease (CKD) and those without CKD (6.3% vs. 7.9%, p = 0.600). Conclusions: This is the first multicenter, large-cohort study to examine cangrelor use in Türkiye, providing real-world evidence for the efficacy and safety in high-risk patients with complex clinical features and lesion characteristics.
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A 2025 study conducted an observational in Acute and chronic coronary syndromes undergoing PCI (n=411). Cangrelor was evaluated on Any bleeding within 48 hours. In a real-world cohort of 411 patients undergoing PCI, cangrelor use was associated with a 6.4% incidence of any bleeding within 48 hours, with major bleeding occurring in 1.7%.
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