Lack of Racial Disparities in Cangrelor Therapy in Patients Presenting With Acute Coronary Syndrome Undergoing
Waiel Abusnina1, Kalyan R Chitturi1, Abhishek Chaturvedi1
1Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.
Insights
Cangrelor effectively treats acute coronary syndrome during PCI, showing no racial disparities in outcomes. African American patients experienced similar safety and efficacy compared to Caucasian patients, with no increased bleeding risk.
Area of Science:
- Cardiology
- Pharmacology
- Health Disparities
Background:
- Cangrelor is an intravenous P2Y12 receptor antagonist used for acute coronary syndrome (ACS) during percutaneous coronary intervention (PCI).
- It provides rapid and potent antiplatelet effects, reducing ischemic events.
Purpose of the Study:
- To investigate potential racial disparities in the use and outcomes of cangrelor in ACS patients undergoing PCI.
- To assess the impact of race on safety (bleeding) and efficacy (major adverse cardiac events) outcomes.
Main Methods:
- Retrospective review of 1181 ACS patients treated with cangrelor during PCI (2018-2023).
- Patients were divided into African American (AA) and Caucasian groups.
- Primary outcomes: in-hospital TIMI major bleeding and major adverse cardiac events (MACE). Multivariate regression analysis was used.
Main Results:
- African American patients were younger and had higher rates of comorbidities (hypertension, diabetes, ESRD).
- No significant differences were found in in-hospital TIMI major bleeding (OR: 0.55; 95% CI: 0.16-1.88) or MACE (OR: 1.82; 95% CI: 0.71-4.69) between AA and Caucasian patients after adjustment.
- These findings were consistent after controlling for baseline characteristics.
Conclusions:
- No racial disparities were observed in cangrelor administration or outcomes for ACS patients undergoing PCI.
- Cangrelor was not associated with increased bleeding risk in African American patients compared to Caucasian patients.
Background:
Cangrelor is an intravenous P2Y12 receptor antagonist that exerts rapid and potent antiplatelet effects. It is associated with a reduction in the indcidence of ischemic events in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).
Aims:
The aim of our study was to investigate the racial disparities and their impact on outcomes among patients with ACS who were treated with cangrelor during PCI.
Methods:
We reviewed the data of patients with ACS who were treated with cangrelor during PCI at our center from 2018 to 2023 and divided between African American (AA) and Caucasian patients. The primary safety outcome was in-hospital thrombolysis in myocardial infarction (TIMI) major bleeding. The primary efficacy outcome was in-hospital major adverse cardiac events (MACE), defined as a composite of cardiac death, MI, or stroke. Multivariate regression analysis was performed to assess the primary outcomes after controlling for differences in baseline characteristics.
Results:
The study included 1181 patients who received cangrelor during PCI for ACS, including 616 AA and 565 Caucasian patients. AA patients were significantly younger (61 ± 13 vs. 64 ± 12 years; p < 0.001) and had higher rates of hypertension, diabetes mellitus, and end-stage renal disease requiring dialysis. There were no significant differences between AA and Caucasian patients regarding in-hospital TIMI major bleeding (odds ratio [OR]: 0.55; 95% confidence interval [CI]: 0.16-1.88; p = 0.343) and in-hospital MACE (OR: 1.82; 95% CI: 0.71-4.69; p = 0.212) after controlling for relevant baseline differences.
Conclusion:
No racial disparities were observed with regard to the administration of cangrelor during PCI in patients presenting with ACS, and cangrelor was not associated with increased bleeding for AA patients as compared to Caucasian patients.
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