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International journal of cardiology v.250, 2018년, pp.49 - 55   SCI SCIE
본 등재정보는 저널의 등재정보를 참고하여 보여주는 베타서비스로 정확한 논문의 등재여부는 등재기관에 확인하시기 바랍니다.

Cangrelor compared with clopidogrel in patients with prior myocardial infarction – Insights from the CHAMPION trials

Eisen, Alon (Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, MA, USA ) ; Harrington, Robert A. (Stanford University, Palo Alto, CA, USA ) ; Stone, Gregg W. (Columbia University Medical Center, New York, NY, USA ) ; Steg, Ph. Gabriel (Université ) ; Gibson, C. Michael (Paris-Diderot, Sorbonne Paris Cité, INSERM U-1148, DHU FIRE, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France ) ; Hamm, Christian W. (Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA ) ; Price, Matthew J. (Kerckhoff Clinic and Thoraxcenter, Bad Nauheim, Germany ) ; Prats, Jayne (Scripps Clinic, La Jolla, CA, USA ) ; Deliargyris, Efthymios N. (Elysis, Carlisle, MA, USA ) ; Mahaffey, Kenneth W. (Science and Strategy Consulting Group, Basking Ridge, NJ, USA ) ; White, Harvey D. (Stanford University, Palo Alto, CA, USA ) ; Bhatt, Deepak L. (University of Auckland, Auckland City Hospital, Auckland, New Zealand ) ;
  • 초록  

    Abstract Background Patients who have had a prior myocardial infarction (MI) are at increased risk for adverse outcomes after subsequent percutaneous coronary intervention (PCI). Objective The objective of this study is to examine the efficacy and safety of cangrelor, a potent intravenous P2Y 12 inhibitor, in patients with prior MI. Methods Pooled data from the CHAMPION trials were examined. Prior MI was defined as a history of MI, excluding MI events at baseline. The primary endpoint was a composite of death, MI, ischemia-driven revascularization, or stent thrombosis at 48-h post-randomization. The primary safety endpoint was GUSTO-defined severe bleeding at 48h. Results Out of 24,691 patients, 5699 (23%) had a prior MI. The primary endpoint was higher in patients with vs. without prior MI (4.9% vs. 4.0%, p = 0.002). The primary endpoint was 4.2% with cangrelor vs. 5.7% with clopidogrel (absolute risk reduction=1.5%; OR 0.72 [95%CI 0.57–0.92]) in patients with prior MI and 3.7% with cangrelor vs. 4.3% with clopidogrel (absolute risk reduction=0.6%; OR 0.85 [95%CI 0.74–0.99]) in patients without prior MI ( P -interaction=0.25). The rate of GUSTO-defined severe bleeding was 0.1% with cangrelor vs. 0.1% with clopidogrel (OR 1.39 [95%CI 0.31–6.24]) in patients with prior MI, and 0.2% with cangrelor vs. 0.2% with clopidogrel (OR 1.18 [95%CI 0.65–2.14]) in patients without prior MI ( P -interaction=0.84). Conclusion In the CHAMPION trials, patients with prior MI had higher rates of ischemic outcomes within 48h after PCI. Cangrelor reduced ischemic events with no significant increase in GUSTO-defined severe bleeding in patients with or without prior MI.


  • 주제어

    Prior myocardial infarction .   Antiplatelet therapy .   Cangrelor .   Percutaneous coronary intervention .   Stent thrombosis.  

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