Background: Oral antiplatelet agents have a limitation in their duration of action and bioavailability. Cangrelor is an intravenous adenosine diphosphate (ADP) inhibitor that has a powerful effect, is rapid and reversible within one hour and with the advantage of intravenous administration that reduces variability in the bioavailability of the drug. The study was designed to compare the efficacy and safety profile of cangrelor with the standard treatment for patients requiring percutaneous coronary intervention (PCI).
Methods and results: a multicenter, randomized, double-blind study in which the primary efficacy end point was a composite of death, infarction, ischemia-driven revascularization or stent thrombosis within 48 hours. We included 11,145 patients undergoing elective or urgent angioplasita, (stable ischemic heart disease, acute coronary syndrome with or without ST segment elevation), to receive cangrelor bolus plus an infusion or a dose of 600 mg or 300 mg of clopidogrel. The clinical characteristics were similar between groups. The primary endpoint was 4.7% in the cangrelor group and 5.9% in the clopidogrel group, (p = 0.005). Stent thrombosis and infarction were lower in the cangrelor group, with no difference in major bleeding between groups.
Conclusions: In the CHAMPION PHOENIX study, the administration of cangrelor significantly reduced the combined endpoint of death and infarction by 22%. The secondary end point of stent thrombosis at forty-eight hours was reduced by 38%. These benefits were maintained for thirty days. There were no differences in bleeding and/or an increased need for transfusion between groups
Deepak Bhatt
2013-03-12
Original title: A Clinical Trial Comparing Cangrelor to Clopidogrel Standard Therapy in Subjects Who Require Percutaneous Coronary Intervention (PCI) (CHAMPION PHOENIX)
