This prospective registry was designed to carefully investigate the pharmacodynamic (PD) effects of cangrelor in all patients undergoing percutaneous coronary intervention (PCI).
There is huge interest in achieving fast and immediate antiplatelet effect at the time of PCI, particularly in acute myocardial infarction and Cangrelor is an intravenous antagonist of the P2Y12 receptor characterized by rapid, potent, predictable, and reversible platelet inhibition. However, there are limited pharmacodynamic data exploring the effects of this drug in the various clinical settings at the approved dosages and with current gold standard methods for testing platelet reactivity. More importantly, there are no data on rates and predictors of high residual platelet reactivity (HRPR) in patients treated with cangrelor. Therefore the present study aims at building up a large prospective registry of pharmacodynamic data obtained by light transmittance aggregometry (LTA), multiplate analysis and verifynow system in patients undergoing PCI and receiving cangrelor. This study is designed as a single-center prospective registry. Investigators at University Hospital of Naples Federico II will enroll patients, collect blood samples, perform platelet function tests and collect clinical and demographic information.
Study Type
OBSERVATIONAL
Enrollment
150
All patients receiving Cangrelor during PCI will be enrolled and analyzed for platelet function tests.
University Federico II of Naples
Napoli, Italy
Inhibition of platelet activity (IPA, %) with LTA-ADP 20 µmol/l
Platelet inhibition assessed with LTA-ADP 20 µmol/l at 30 minutes and after infusion stop
Time frame: 30 minutes
Maximum platelet aggregation (MPA) with LTA-ADP 20 µmol/l
Platelet aggregation assessed with LTA-ADP 20 µmol/l at 30 minutes and after infusion stop
Time frame: 30 minutes
Rates of High Residual Platelet Reactivity (HRPR) with LTA-ADP 20 µmol/l defined as MPA>59%
High platelet aggregation assessed with LTA-ADP 20 µmol/l at 30 minutes and after infusion stop
Time frame: 30 minutes
Inhibition of platelet activity (IPA, %) with LTA-ADP 5 µmol/l
Platelet inhibition assessed with LTA-ADP 5 µmol/l at 30 minutes and after infusion stop
Time frame: 30 minutes
Maximum platelet aggregation (MPA) with LTA-ADP 5 µmol/l
Platelet aggregation assessed with LTA-ADP 5 µmol/l at 30 minutes and after infusion stop
Time frame: 30 minutes
Rates of High Residual Platelet Reactivity with LTA-ADP 5 µmol/l defined as MPA>46%
High platelet aggregation assessed with LTA-ADP 5 µmol/l at 30 minutes and after infusion stop
Time frame: 30 minutes
Area under the curve (AUC) at Multiplate with ADP test
Platelet aggregation assessed with Multiplate ADP test at 30 minutes and after infusion stop
Time frame: 30 minutes
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Rates of HRPR defined as Multiplate AUC >46 U
High platelet aggregation assessed with Multiplate ADP test at 30 minutes and after infusion stop
Time frame: 30 minutes
P2Y12 Reaction Unit (PRU) at VerifyNow
Platelet aggregation assessed with VerifyNow ADP test at 30 minutes and after infusion stop
Time frame: 30 minutes
Rates of HRPR defined as VerifyNow PRU >208
High platelet aggregation assessed with VerifyNow ADP test at 30 minutes and after infusion stop
Time frame: 30 minutes
Platelet aggregation, inhibition and HRPR by LTA, Multiplate and VerifyNow
Platelet aggregation, inhibition and HRPR by LTA, Multiplate and VerifyNow few hours after cangrelor infusion interruption
Time frame: After stop of cangrelor infusion
Clinical outcomes at 30 days
Ischemic and bleeding outcomes at 30 days
Time frame: 30 day