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Use of Cangrelor in Türkiye: A Multicenter Real-Life Study.

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This study shows cangrelor is effective and safe for high-risk patients undergoing percutaneous coronary intervention (PCI) in Türkiye. Real-world data confirm its utility when oral P2Y12 inhibitors are not feasible, with low bleeding rates.

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Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Cangrelor is the sole intravenous P2Y12 inhibitor for acute and chronic coronary syndromes.
  • Existing research confirms cangrelor's efficacy, but real-world usage data remain limited.
  • This study addresses the need for real-world evidence on cangrelor in high-volume percutaneous coronary intervention (PCI) centers.

Purpose of the Study:

  • To investigate cangrelor utilization in large-volume PCI centers in Türkiye.
  • To analyze indications, patient demographics, and clinical outcomes, including bleeding and ischemic events.
  • To evaluate the efficacy and safety of cangrelor in a high-risk patient cohort.

Main Methods:

  • Retrospective analysis of 411 patients from 14 high-volume centers in Türkiye with extensive cangrelor experience.
  • Data collected on cangrelor indications, patient characteristics, treatments, and in-hospital/follow-up events.
  • Analysis included bleeding events (any and major), ischemic events, and mortality.

Main Results:

  • Common indications for cangrelor included cardiogenic shock and inability to take oral P2Y12 inhibitors due to nausea/vomiting or intubation.
  • Overall bleeding incidence within 48 hours was 6.4%, with major bleeding at 1.7%.
  • Bleeding rates were comparable across age groups (<75 vs. ≥75 years) and in patients with/without chronic kidney disease (CKD).

Conclusions:

  • This is the first large-scale, multicenter study on cangrelor use in Türkiye.
  • Provides crucial real-world evidence supporting cangrelor's efficacy and safety in high-risk PCI patients.
  • Highlights cangrelor's value in complex clinical scenarios where oral P2Y12 inhibitors are not suitable.