Waiel Abusnina, Kalyan R Chitturi, Abhishek Chaturvedi, Lior Lupu, Dan Haberman, Matteo Cellamare, Vaishnavi Sawant, Cheng Zhang, Itsik Ben-Dor, Lowell F Satler, Hayder D Hashim, Brian C Case, Ron Waksman
{"title":"Lack of Racial Disparities in Cangrelor Therapy in Patients Presenting With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.","authors":"Waiel Abusnina, Kalyan R Chitturi, Abhishek Chaturvedi, Lior Lupu, Dan Haberman, Matteo Cellamare, Vaishnavi Sawant, Cheng Zhang, Itsik Ben-Dor, Lowell F Satler, Hayder D Hashim, Brian C Case, Ron Waksman","doi":"10.1002/ccd.31442","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cangrelor is an intravenous P2Y12 receptor antagonist that exerts rapid and potent antiplatelet effects. It is associated with a reduction in the indcidence of ischemic events in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).</p><p><strong>Aims: </strong>The aim of our study was to investigate the racial disparities and their impact on outcomes among patients with ACS who were treated with cangrelor during PCI.</p><p><strong>Methods: </strong>We reviewed the data of patients with ACS who were treated with cangrelor during PCI at our center from 2018 to 2023 and divided between African American (AA) and Caucasian patients. The primary safety outcome was in-hospital thrombolysis in myocardial infarction (TIMI) major bleeding. The primary efficacy outcome was in-hospital major adverse cardiac events (MACE), defined as a composite of cardiac death, MI, or stroke. Multivariate regression analysis was performed to assess the primary outcomes after controlling for differences in baseline characteristics.</p><p><strong>Results: </strong>The study included 1181 patients who received cangrelor during PCI for ACS, including 616 AA and 565 Caucasian patients. AA patients were significantly younger (61 ± 13 vs. 64 ± 12 years; p < 0.001) and had higher rates of hypertension, diabetes mellitus, and end-stage renal disease requiring dialysis. There were no significant differences between AA and Caucasian patients regarding in-hospital TIMI major bleeding (odds ratio [OR]: 0.55; 95% confidence interval [CI]: 0.16-1.88; p = 0.343) and in-hospital MACE (OR: 1.82; 95% CI: 0.71-4.69; p = 0.212) after controlling for relevant baseline differences.</p><p><strong>Conclusion: </strong>No racial disparities were observed with regard to the administration of cangrelor during PCI in patients presenting with ACS, and cangrelor was not associated with increased bleeding for AA patients as compared to Caucasian patients.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Catheterization and Cardiovascular Interventions","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ccd.31442","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Cangrelor is an intravenous P2Y12 receptor antagonist that exerts rapid and potent antiplatelet effects. It is associated with a reduction in the indcidence of ischemic events in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).
Aims: The aim of our study was to investigate the racial disparities and their impact on outcomes among patients with ACS who were treated with cangrelor during PCI.
Methods: We reviewed the data of patients with ACS who were treated with cangrelor during PCI at our center from 2018 to 2023 and divided between African American (AA) and Caucasian patients. The primary safety outcome was in-hospital thrombolysis in myocardial infarction (TIMI) major bleeding. The primary efficacy outcome was in-hospital major adverse cardiac events (MACE), defined as a composite of cardiac death, MI, or stroke. Multivariate regression analysis was performed to assess the primary outcomes after controlling for differences in baseline characteristics.
Results: The study included 1181 patients who received cangrelor during PCI for ACS, including 616 AA and 565 Caucasian patients. AA patients were significantly younger (61 ± 13 vs. 64 ± 12 years; p < 0.001) and had higher rates of hypertension, diabetes mellitus, and end-stage renal disease requiring dialysis. There were no significant differences between AA and Caucasian patients regarding in-hospital TIMI major bleeding (odds ratio [OR]: 0.55; 95% confidence interval [CI]: 0.16-1.88; p = 0.343) and in-hospital MACE (OR: 1.82; 95% CI: 0.71-4.69; p = 0.212) after controlling for relevant baseline differences.
Conclusion: No racial disparities were observed with regard to the administration of cangrelor during PCI in patients presenting with ACS, and cangrelor was not associated with increased bleeding for AA patients as compared to Caucasian patients.
期刊介绍:
Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.