Transitioning from Cangrelor to Oral P2Y12 Inhibitors in Patients with ACS: Insights from the ARCANGELO Study.

IF 2.1 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Current vascular pharmacology Pub Date : 2025-06-02 DOI:10.2174/0115701611309982250522065849

Leonardo De Luca, Paolo Calabrò, Piera Capranzano, Elisa Nicolini, Ciro Mauro, Carlo Trani, Francesco Versaci, Fabrizio Tomai, Alessio Mattesini, Martino Pepe, Sergio Berti, Carlo Cernetti, Giuseppe Musumeci, Plinio Cirillo

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引用次数: 0

Abstract

Aims: The present analysis of the ARCANGELO study aims to investigate the effect of switching to different oral P2Y12 inhibitors when using cangrelor during PCIs in patients with ACS.

Methods: Out of the 995 patients meeting the criteria for this investigation, 138 transitioned to Clopidogrel (CLO), 127 to rasugrel (PRA), and 730 to Ticagrelor (TICA). Compared to the patients on PRA or TICA, users of CLO were older (median (Q1-Q3) 74(64-81) years CLO, 59(54-65) years PRA, 65(56-73) TICA; p<0.0001), had more comorbidities (37.0% CLO, 17.3% PRA, 18.9% TICA, p<0.0001), and had more frequently an NSTEMI diagnosis (68.1% CLO vs 33.1% PRA vs 35.9% TICA, p<0.0001).

Results: Five moderate bleeds were recorded without any severe episodes. There were no significant differences in the bleeding rate when switching to the different oral P2Y12 inhibitors (2.2% CLO, 5.3% TICA, 7.9% PRA, p = 0.0705) while different incidences of MACEs (4.3% CLO, 1.1% TICA, 0% PRA, p = 0.0113) and NACEs (4.3% CLO, 1.8% TICA, 0% PRA, p=0.0321) were observed during the 30 days of the study.

Conclusion: The use of cangrelor and the switch to any oral P2Y12 inhibitor in compliance with the EU SmPC is safe, with a low risk of ischemic events in routine clinical practice.

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ACS患者从angrelor过渡到口服P2Y12抑制剂：来自ARCANGELO研究的见解

目的：目前对ARCANGELO研究的分析旨在探讨ACS患者pci期间使用康格瑞洛时切换到不同口服P2Y12抑制剂的影响。方法：在995例符合本研究标准的患者中，138例转为氯吡格雷（CLO）， 127例转为瑞格雷（PRA）， 730例转为替格瑞洛（TICA）。与使用PRA或TICA的患者相比，使用CLO的患者年龄更大(中位（Q1-Q3） CLO 74（64-81）岁，PRA 59（54-65）岁，TICA 65（56-73）岁；结果：5例中度出血，无严重出血。切换到不同口服P2Y12抑制剂时，出血率无显著差异（2.2% CLO, 5.3% TICA, 7.9% PRA, p= 0.0705），而在研究的30天内，观察到不同的mace发生率（4.3% CLO, 1.1% TICA, 0% PRA, p= 0.0113）和nace发生率（4.3% CLO, 1.8% TICA, 0% PRA, p=0.0321）。结论：在常规临床实践中，在符合欧盟SmPC的情况下，使用康格洛并切换到任何口服P2Y12抑制剂是安全的，缺血性事件的风险较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current vascular pharmacology 医学-外周血管病

CiteScore

9.20

自引率

4.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Vascular Pharmacology publishes clinical and research-based reviews/mini-reviews, original research articles, letters, debates, drug clinical trial studies and guest edited issues to update all those concerned with the treatment of vascular disease, bridging the gap between clinical practice and ongoing research. Vascular disease is the commonest cause of death in Westernized countries and its incidence is on the increase in developing countries. It follows that considerable research is directed at establishing effective treatment for acute vascular events. Long-term treatment has also received considerable attention (e.g. for symptomatic relief). Furthermore, effective prevention, whether primary or secondary, is backed by the findings of several landmark trials. Vascular disease is a complex field with primary care physicians and nurse practitioners as well as several specialties involved. The latter include cardiology, vascular and cardio thoracic surgery, general medicine, radiology, clinical pharmacology and neurology (stroke units).