{"id":1340,"date":"2009-11-15T16:20:48","date_gmt":"2009-11-15T21:20:48","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/cangrelor-not-beneficial-in%c2%a0acs-patients-receiving-clopidogrel-and-pci\/"},"modified":"2011-07-19T17:44:18","modified_gmt":"2011-07-19T21:44:18","slug":"cangrelor-not-beneficial-in%c2%a0acs-patients-receiving-clopidogrel-and-pci","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2009\/11\/15\/cangrelor-not-beneficial-in%c2%a0acs-patients-receiving-clopidogrel-and-pci\/","title":{"rendered":"Cangrelor Not Beneficial in\u00a0ACS Patients Receiving Clopidogrel and PCI"},"content":{"rendered":"<p>In ACS patients undergoing PCI, giving cangrelor with clopidogrel did not reduce cardiac ischemic events\u00a0(a composite end-point of death, MI, and ischemia-driven revascularization)\u00a0compared with\u00a0clopidogrel alone.<br \/>\n\u00a0\u00a0\u00a0\u00a0\u00a0<br \/>\nSince they both have the same antiplatelet mechanism of action (P2Y12 inhibitor), what\u2019s the rationale for using cangrelor with clopidogrel? <\/p>\n<p>Clopidogrel has two major limitations: its platelet inhibition has a delayed onset of action (hours after it is administered) and is irreversible, which is problematic if CABG is imminent.\u00a0 Conversely, cangrelor has a rapid onset of action (within minutes of its intravenous administration) and is short lasting; its antiplatelet effects resolve within an hour of its discontinuation.\u00a0 <\/p>\n<p>So, although it seems rational to use a rapidly effective, short-acting antiplatelet agent in combination with clopidogrel, it wasn\u2019t beneficial in CHAMPION: 2 large, randomized studies (see\u00a0<a href=\"http:\/\/cardioexchange.org\/nejm\/content\/full\/361\/24\/2318\">here<\/a> and <a href=\"http:\/\/cardioexchange.org\/nejm\/content\/full\/361\/24\/2330\">here<\/a>). <\/p>\n<p>In our Discussion Forum, the investigators and the author of an <a href=\"http:\/\/cardioexchange.org\/nejm\/content\/full\/361\/24\/2382\">invited editorial <\/a>provide their perspectives on the studies.\u00a0 <\/p>\n<p>We invite\u00a0you to join the discussion below.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In ACS patients undergoing PCI, giving cangrelor with clopidogrel did not reduce cardiac ischemic events\u00a0(a composite end-point of death, MI, and ischemia-driven revascularization)\u00a0compared with\u00a0clopidogrel alone. \u00a0\u00a0\u00a0\u00a0\u00a0 Since they both have the same antiplatelet mechanism of action (P2Y12 inhibitor), what\u2019s the rationale for using cangrelor with clopidogrel? Clopidogrel has two major limitations: its platelet inhibition has [&hellip;]<\/p>\n","protected":false},"author":214,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,9],"tags":[],"class_list":["post-1340","post","type-post","status-publish","format-standard","hentry","category-general","category-interventional-cardiology"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/1340","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/214"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=1340"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/1340\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=1340"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=1340"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=1340"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}