Coronary disease & ACSRandomised controlled trial
Effect of Cangrelor on Infarct Size in ST-Segment–Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention: A Randomized Controlled Trial (The PITRI Trial)
- Randomised controlled trial
- phase 2
- multicentre
- double-blind
- placebo-controlled
- 6 cardiac centres in Singapore
- Conducted November 2017 to November 2021
Authors' conclusion
Cangrelor administered at the time of primary percutaneous coronary intervention did not reduce acute MI size or prevent microvascular obstruction in patients with ST-segment-elevation MI given oral ticagrelor despite a significant reduction of platelet reactivity during the percutaneous coronary intervention procedure.
Study context
- Population
- Patients with STEMI undergoing primary PCI164 (78%) completed acute CMR
- Participants
- 209 patients
- Comparison
- Cangrelor vs placebo before primary PCI, on top of oral ticagrelor
- Primary endpoint
- Acute myocardial infarction (MI) size by CMR, as % of LV mass (%LVmass)
- Follow-up
- Within the first week
Primary result
As reported in the abstract
Acute MI size
P = 0.40
Further findings
Incidence of microvascular obstruction
P = 0.99
Extent of microvascular obstruction
P = 0.46
Platelet reactivity
- 2-fold decrease in platelet reactivity with cangrelor
Safety
BARC-defined major bleeding (primary safety end point) · first 48 hours
- No BARC-defined major bleeding events in either group
Original publication
Effect of Cangrelor on Infarct Size in ST-Segment–Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention: A Randomized Controlled Trial (The PITRI Trial). Circulation. Published 14 May 2024. doi:10.1161/circulationaha.124.068938
Summarised from the published abstract; every number is checked against it