| Autor: |
Rymer JA; Division of Cardiology Duke University Medical Center Durham NC.; Duke Clinical Research Institute Durham NC., Bhatt DL; Division of Cardiovascular Medicine Brigham and Women's HospitalHarvard Medical School Boston MA., Angiolillo DJ; Division of Cardiology University of Florida Jacksonville FL., Diaz M; Palmetto General Hospital Hialeah FL., Garratt KN; Division of Cardiology ChristianaCare Wilmington DE., Waksman R; Division of Cardiology MedStar Health Columbia MD., Edwards L; Duke Clinical Research Institute Durham NC., Tasissa G; Duke Clinical Research Institute Durham NC., Salahuddin K; Chiesi USA Cary NC., El-Sabae H; Chiesi USA Cary NC., Dell'Anna C; Chiesi USA Cary NC., Davidson-Ray L; Duke Clinical Research Institute Durham NC., Washam JB; Division of Clinical Pharmacology Duke University Medical Center Durham NC., Ohman EM; Division of Cardiology Duke University Medical Center Durham NC.; Duke Clinical Research Institute Durham NC., Wang TY; Division of Cardiology Duke University Medical Center Durham NC.; Duke Clinical Research Institute Durham NC. |
| Jazyk: |
angličtina |
| Zdroj: |
Journal of the American Heart Association [J Am Heart Assoc] 2022 Jun 07; Vol. 11 (11), pp. e024513. Date of Electronic Publication: 2022 May 27. |
| DOI: |
10.1161/JAHA.121.024513 |
| Abstrakt: |
Background In clinical trials, cangrelor has been shown to reduce percutaneous coronary intervention-related ischemic complications without increasing major bleeding. This study was performed to examine cangrelor use and transition to oral P2Y 12 inhibitors in routine clinical practice. Methods and Results The CAMEO (Cangrelor in Acute Myocardial Infarction: Effectiveness and Outcomes) registry is a multicenter, retrospective observational study of platelet inhibition strategies for patients with myocardial infarction undergoing percutaneous coronary intervention. In phase 1, data were collected on consecutive patients with myocardial infarction (n=482) treated with any P2Y 12 inhibitor to understand cangrelor use by hospital. In phase 2, data were collected in a 2:1 (cangrelor-: non-cangrelor-treated) ratio of patients with myocardial infarction (n=873). In phase 1, cangrelor use varied across hospitals (overall, 50.4% [range, 6.0%-100%]). Of patients receiving cangrelor in both phases (n=819), 3.3% received either the bolus or infusion only. Cangrelor was infused for a median of 121 (76-196) minutes; and 38.3% received an infusion for <2 hours. Most patients transitioned from cangrelor to ticagrelor (ticagrelor, 85.3%; clopidogrel, 9.5%; prasugrel, 5.2%). Many patients (16.4%) had a >1-hour gap between cangrelor cessation and oral P2Y 12 inhibitor initiation; this was highest among those transitioned to clopidogrel (56.6% versus 34.5% prasugrel versus 10.8% ticagrelor; P <0.001). Only 27.3% were dosed with cangrelor and transitioned to an oral P2Y 12 inhibitor in a fashion consistent with the pivotal trials and US Food and Drug Administration label. Conclusions This multicenter registry demonstrated interhospital variability in how cangrelor was administered and transitioned to an oral P2Y 12 inhibitor. These findings highlight opportunities for optimization of cangrelor dosing, infusion duration, and transition of care from the catheterization laboratory to the ward setting. |
| Databáze: |
MEDLINE |
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