Platelet Inhibition With Cangrelor and Crushed Ticagrelor in STEMI
Status:
Completed
Trial end date:
2018-12-13
Target enrollment:
Participant gender:
Summary
In STEMI patients undergoing PPCI there is a delayed onset of action of oral P2Y12 receptor
inhibitors, including prasugrel and ticagrelor. Crushing prasugrel and ticagrelor improves
their PK and PD profiles as it favors drug absorption and onset of antiplatelet effects and
because of this, it is commonly used in STEMI patients undergoing PPCI. However, despite the
use of crushed tablets, up to one-third of patients may still have high on-treatment platelet
reactivity (HPR) within the first 2 hours after loading dose (LD) administration of these
oral agents. Cangrelor is a potent intravenous P2Y12 receptor inhibitor with rapid onset and
offset of action associated with a greater reduction in ischemic events compared with
clopidogrel in P2Y12 receptor naïve patients undergoing PCI. To date most studies have
explored cangrelor in the setting of PCI subjects treated with clopidogrel. The PD effects of
cangrelor in STEMI patients undergoing PPCI treated with a newer generation P2Y12 receptor
inhibitor and how this compares with a crushed formulation of the oral drug is unexplored.
The aim of this prospective randomized study is to investigate the PD effects of cangrelor in
STEMI patients undergoing PPCI treated with crushed ticagrelor.