Coronary disease & ACSRandomised controlled trial
Switching From Cangrelor to Prasugrel in Patients Undergoing Percutaneous Coronary Intervention
- Randomised controlled trial
- 3-arm
- open-label
- prospective
- pharmacokinetic and pharmacodynamic study
- non-inferiority
Authors' conclusion
In patients undergoing PCI, concomitant administration of prasugrel with cangrelor leads to a marked increase in platelet reactivity after stopping cangrelor infusion, supporting the presence of a DDI.
Study context
- Population
- Patients undergoing percutaneous coronary intervention (PCI)
- Participants
- 77 patients
- Comparison
- Cangrelor plus prasugrel concomitantly vs prasugrel only
- Primary endpoint
- Non-inferiority in VerifyNow P2Y12 reaction units, cangrelor plus prasugrel concomitantly vs prasugrel only
- Follow-up
- 4 hours after randomization
Primary result
P2Y12 reaction units · 4 hours postrandomization
Least squares means difference
130
95% CI 85–176
Cangrelor plus prasugrel concomitantly vs Prasugrel only
least squares means difference 130 (95% CI 85–176)
As reported in the abstract
Further findings
Active metabolite of prasugrel plasma levels
- Not affected by concomitant cangrelor; low at the end of cangrelor infusion
Other pharmacodynamic (PD) assays
- Findings corroborated by multiple PD assays
Original publication
Switching From Cangrelor to Prasugrel in Patients Undergoing Percutaneous Coronary Intervention. JACC Cardiovasc Interv. Published 21 August 2023. doi:10.1016/j.jcin.2023.08.009
Summarised from the published abstract; every number is checked against it