Pharmacodynamic effects of cangrelor in patients with acute or chronic coronary syndrome undergoing percutaneous coronary intervention: the POMPEII Registry
Authors' conclusion
Cangrelor provided effective platelet inhibition in most patients with ACS or CCS undergoing PCI, including those with STEMI who were pretreated with ticagrelor. Switching from cangrelor to an oral P2Y12 inhibitor, mainly clopidogrel, exposed a large number of patients to a variable period of on-treatment HRPR.
Study context
- Population
- Patients with acute or chronic coronary syndrome undergoing percutaneous coronary intervention (PCI) and receiving cangrelorpatients undergoing PCI and receiving cangrelor, enrolled March 2021 to June 2024 · elective PCI 64 · non-ST-elevation acute coronary syndrome 30 · STEMI 56 · STEMI pretreated with ticagrelor (of the 56 with STEMI) 24
- Participants
- 150 patients
- Exposure
- Elective PCI vs non-ST-elevation acute coronary syndrome vs STEMI
- Elective PCIn = 64
- non-ST-elevation acute coronary syndromen = 30
- STEMIn = 56
- Outcome
- Inhibition of platelet aggregation during cangrelor infusion (light transmittance aggregometry with adenosine diphosphate 20 μM)
- Follow-up
- During cangrelor infusion
Main finding
As reported in the abstract
Inhibition of platelet aggregation (moderate)
57.6±16.5%
High residual platelet reactivity (HRPR)
3.2%
Bailout tirofiban
1.3%
Observational data: associations, not effects.
Further findings
Rates of HRPR after cangrelor · 3 h and 4-6 h
- HRPR at 3 h
- 37.9%
- HRPR at 4-6 h
- 15.3%
- HRPR significantly more frequent in patients switching to clopidogrel compared with ticagrelor
Switching from cangrelor
- Most patients switched from cangrelor to either clopidogrel or ticagrelor
Safety
Ischaemic and bleeding events · 30 days
- Rates of ischaemic and bleeding events were low
Original publication
Pharmacodynamic effects of cangrelor in patients with acute or chronic coronary syndrome undergoing percutaneous coronary intervention: the POMPEII Registry. EuroIntervention. Published 16 May 2025. doi:10.
Summarised from the published abstract; every number is checked against it