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Cangrelor Use Patterns and Transition to Oral P2Y12 Inhibitors Among Patients With Myocardial Infarction: Initial Results From the CAMEO Registry.

Publication ,  Journal Article
Rymer, JA; Bhatt, DL; Angiolillo, DJ; Diaz, M; Garratt, KN; Waksman, R; Edwards, L; Tasissa, G; Salahuddin, K; El-Sabae, H; Dell'Anna, C ...
Published in: J Am Heart Assoc
June 7, 2022

Background In clinical trials, cangrelor has been shown to reduce percutaneous coronary intervention-related ischemic complications without increasing major bleeding. This study was performed to examine cangrelor use and transition to oral P2Y12 inhibitors in routine clinical practice. Methods and Results The CAMEO (Cangrelor in Acute Myocardial Infarction: Effectiveness and Outcomes) registry is a multicenter, retrospective observational study of platelet inhibition strategies for patients with myocardial infarction undergoing percutaneous coronary intervention. In phase 1, data were collected on consecutive patients with myocardial infarction (n=482) treated with any P2Y12 inhibitor to understand cangrelor use by hospital. In phase 2, data were collected in a 2:1 (cangrelor-: non-cangrelor-treated) ratio of patients with myocardial infarction (n=873). In phase 1, cangrelor use varied across hospitals (overall, 50.4% [range, 6.0%-100%]). Of patients receiving cangrelor in both phases (n=819), 3.3% received either the bolus or infusion only. Cangrelor was infused for a median of 121 (76-196) minutes; and 38.3% received an infusion for <2 hours. Most patients transitioned from cangrelor to ticagrelor (ticagrelor, 85.3%; clopidogrel, 9.5%; prasugrel, 5.2%). Many patients (16.4%) had a >1-hour gap between cangrelor cessation and oral P2Y12 inhibitor initiation; this was highest among those transitioned to clopidogrel (56.6% versus 34.5% prasugrel versus 10.8% ticagrelor; P<0.001). Only 27.3% were dosed with cangrelor and transitioned to an oral P2Y12 inhibitor in a fashion consistent with the pivotal trials and US Food and Drug Administration label. Conclusions This multicenter registry demonstrated interhospital variability in how cangrelor was administered and transitioned to an oral P2Y12 inhibitor. These findings highlight opportunities for optimization of cangrelor dosing, infusion duration, and transition of care from the catheterization laboratory to the ward setting.

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Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

June 7, 2022

Volume

11

Issue

11

Start / End Page

e024513

Location

England

Related Subject Headings

  • Treatment Outcome
  • Ticagrelor
  • Registries
  • Purinergic P2Y Receptor Antagonists
  • Prasugrel Hydrochloride
  • Platelet Aggregation Inhibitors
  • Percutaneous Coronary Intervention
  • Myocardial Infarction
  • Humans
  • Clopidogrel
 

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Rymer, J. A., Bhatt, D. L., Angiolillo, D. J., Diaz, M., Garratt, K. N., Waksman, R., … Wang, T. Y. (2022). Cangrelor Use Patterns and Transition to Oral P2Y12 Inhibitors Among Patients With Myocardial Infarction: Initial Results From the CAMEO Registry. J Am Heart Assoc, 11(11), e024513. https://doi.org/10.1161/JAHA.121.024513
Rymer, Jennifer A., Deepak L. Bhatt, Dominick J. Angiolillo, Miguel Diaz, Kirk N. Garratt, Ron Waksman, Laura Edwards, et al. “Cangrelor Use Patterns and Transition to Oral P2Y12 Inhibitors Among Patients With Myocardial Infarction: Initial Results From the CAMEO Registry.J Am Heart Assoc 11, no. 11 (June 7, 2022): e024513. https://doi.org/10.1161/JAHA.121.024513.
Rymer JA, Bhatt DL, Angiolillo DJ, Diaz M, Garratt KN, Waksman R, et al. Cangrelor Use Patterns and Transition to Oral P2Y12 Inhibitors Among Patients With Myocardial Infarction: Initial Results From the CAMEO Registry. J Am Heart Assoc. 2022 Jun 7;11(11):e024513.
Rymer, Jennifer A., et al. “Cangrelor Use Patterns and Transition to Oral P2Y12 Inhibitors Among Patients With Myocardial Infarction: Initial Results From the CAMEO Registry.J Am Heart Assoc, vol. 11, no. 11, June 2022, p. e024513. Pubmed, doi:10.1161/JAHA.121.024513.
Rymer JA, Bhatt DL, Angiolillo DJ, Diaz M, Garratt KN, Waksman R, Edwards L, Tasissa G, Salahuddin K, El-Sabae H, Dell’Anna C, Davidson-Ray L, Washam JB, Ohman EM, Wang TY. Cangrelor Use Patterns and Transition to Oral P2Y12 Inhibitors Among Patients With Myocardial Infarction: Initial Results From the CAMEO Registry. J Am Heart Assoc. 2022 Jun 7;11(11):e024513.
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

June 7, 2022

Volume

11

Issue

11

Start / End Page

e024513

Location

England

Related Subject Headings

  • Treatment Outcome
  • Ticagrelor
  • Registries
  • Purinergic P2Y Receptor Antagonists
  • Prasugrel Hydrochloride
  • Platelet Aggregation Inhibitors
  • Percutaneous Coronary Intervention
  • Myocardial Infarction
  • Humans
  • Clopidogrel