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Cangrelor in percutaneous coronary interventions: advances in evidence, clinical applications, and future directions

Vincenzo De Sio1,2, Felice Gragnano1,2, Arturo Cesaro1,2

  • 1Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Caserta, Italy.

Expert Review of Cardiovascular Therapy
|August 8, 2025
PubMed

Insights

Cangrelor, an intravenous P2Y12 inhibitor, effectively prevents clots during percutaneous coronary intervention (PCI). Despite proven benefits, its use is inconsistent due to cost and data gaps in specific patient groups.

Area of Science:

  • Cardiology
  • Pharmacology
  • Interventional Cardiology

Background:

  • Cangrelor is the sole parenteral P2Y12 receptor antagonist for preventing periprocedural thrombotic complications in P2Y12 inhibitor-naïve patients undergoing percutaneous coronary intervention (PCI).

Purpose of the Study:

  • To comprehensively analyze cangrelor's pharmacology and administration in PCI.
  • To summarize current clinical and real-world evidence on cangrelor.
  • To discuss future applications and address utilization barriers.

Main Methods:

  • Literature search conducted using PubMed up to May 2025.
  • Comprehensive review of pharmacological properties and administration strategies.
  • Analysis of clinical trials and real-world studies.

Main Results:

  • Cangrelor offers rapid platelet inhibition with a predictable pharmacokinetic profile, aiding perioperative management.
  • The CHAMPION program showed cangrelor significantly reduced early ischemic events versus clopidogrel in PCI.
  • Inconsistent adoption is noted, with frequent reports of misuse.

Conclusions:

  • Barriers to cangrelor utilization include cost, concerns about switching to oral agents, limited data in high-risk populations, and lack of direct comparisons with ticagrelor or prasugrel.
  • Further research and clear guidelines may enhance cangrelor's appropriate use in PCI.
Abstract

Keywords:
CangrelorP2Y12 inhibitorsantiplatelet drugsischemic heart diseasepercutaneous coronary intervention

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