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Cangrelor

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https://www.readbyqxmd.com/read/27922911/meta-analysis-of-comparison-of-the-newer-p2y12-inhibitors-oral-preparation-or-intravenous-to-clopidogrel-in-patients-with-acute-coronary-syndrome
#1
Lu Zhang, Jun Lu, Weihua Dong, Huiping Tian, Weiyi Feng, Haisheng You, Hairong He, Jing Ma, Yalin Dong
AIMS: New P2Y12 adenosine diphosphate receptor antagonist that has been used in the treatment of acute coronary syndrome (ACS) with mixed results. This systematic review analyzed and compared the evidence from large, clinical trials regarding the efficacy of clopidogrel relative to that of cangrelor, prasugrel, and ticagrelor in reducing the incidence of cardiovascular events in patients with ACS. METHODS AND RESULTS: This analysis of the findings for comparing newer P2Y12 inhibitors with clopidogrel of 13 clinical trials involving a total of 87,985 patients with ACS ...
November 29, 2016: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/27902833/evaluation-of-ischemic-and-bleeding-risks-associated-with-2-parenteral-antiplatelet-strategies-comparing-cangrelor-with-glycoprotein-iib-iiia-inhibitors-an-exploratory-analysis-from-the-champion-trials
#2
Muthiah Vaduganathan, Robert A Harrington, Gregg W Stone, Efthymios N Deliargyris, Ph Gabriel Steg, C Michael Gibson, Christian W Hamm, Matthew J Price, Alberto Menozzi, Jayne Prats, Steven Elkin, Kenneth W Mahaffey, Harvey D White, Deepak L Bhatt
Importance: In the context of contemporary pharmacotherapy, optimal antiplatelet management with percutaneous coronary intervention (PCI) has not been well established. Objective: To compare the ischemic and bleeding risks associated with glycoprotein IIb/IIIa inhibitors (GPIs) and a potent P2Y12 antagonist, cangrelor, in patients undergoing PCI. Design, Setting, and Participants: An exploratory analysis of pooled patient-level data from the 3 phase 3 Cangrelor vs Standard Therapy to Achieve Optimal Management of Platelet Inhibition (CHAMPION PCI, CHAMPION PLATFORM, and CHAMPION PHOENIX) trials of patients undergoing elective or nonelective PCI...
November 30, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27886821/cangrelor-pharmacology-clinical-data-and-role-in-percutaneous-coronary-intervention
#3
REVIEW
Matthew J Price
In clinical trials that assessed the safety and efficacy of cangrelor during percutaneous coronary intervention (PCI), cangrelor was administered as a 30-μg/kg bolus followed by a 4-μg/kg/min infusion for at least 2 hours or the duration of the PCI, whichever was longer. Cangrelor is currently indicated as an adjunct to PCI to reduce the risk of myocardial infarction, repeat coronary revascularization, and stent thrombosis in patients who have not been treated with a P2Y12 platelet inhibitor and are not being given a glycoprotein IIb/IIIa inhibitor...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27885888/cangrelor-in-combination-with-ticagrelor-provides-consistent-and-potent-p2y12-inhibition-during-and-after-primary-percutaneous-coronary-intervention-in-real-world-patients-with-st-segment-elevation-myocardial-infarction
#4
Moman A Mohammad, Pontus Andell, Sasha Koul, Stefan James, Fredrik Scherstén, Matthias Götberg, David Erlinge
Patients pretreated with ticagrelor with less than 1 hour from percutaneous coronary intervention (PCI) or receiving ticagrelor in cath lab were prospectively included and received cangrelor. Cangrelor was infused for 2 hours and platelet function was assessed as P2Y12 reactivity units (PRU) with the VerifyNow P2Y12 function assay before start of infusion, 15 min after the start of infusion, and 30 min after the end of infusion. A total of n = 32 patients with an average age of 68 (±13) years with n = 22 (69%) males were included...
November 25, 2016: Platelets
https://www.readbyqxmd.com/read/27848264/underlying-mechanism-and-specific-prevention-of-hemolysis-induced-platelet-activation
#5
Thomas Gremmel, Simone Fedrizzi, Günter Weigel, Beate Eichelberger, Simon Panzer
Thromboembolic complications significantly impair the outcome of hemolytic disorders. We hypothesized that red cell adenosine diphosphate (ADP) release results in significant platelet activation in hemolysis and that this prothrombotic state can be prevented by inhibition of the ADP P2Y12 receptor. In the current study, we therefore sought to investigate the mechanism and inhibition of hemolysis-induced platelet activation. The expression of activated integrin αIIbß3 was determined by flow cytometry, and platelet aggregation was assessed by multiple electrode platelet aggregometry...
November 16, 2016: Platelets
https://www.readbyqxmd.com/read/27837449/erratum-to-optimizing-the-use-of-cangrelor-in-the-real-world
#6
Arman Qamar, Deepak L Bhatt
No abstract text is available yet for this article.
November 11, 2016: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/27729681/cangrelor
#7
EDITORIAL
Danial E Baker, Kyle T Ingram
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are sent in print and are also available on-line...
November 2015: Hospital Pharmacy
https://www.readbyqxmd.com/read/27714642/role-of-new-antiplatelet-drugs-on-cardiovascular-disease-update-on-cangrelor
#8
Ana Lucrecia Marcano, José Luis Ferreiro
Dual therapy with a P2Y12 receptor antagonist in addition to aspirin is the antiplatelet treatment of choice in patients with acute coronary syndromes or undergoing percutaneous coronary intervention (PCI). However, available oral P2Y12 antagonists have several limitations, mostly due to their pharmacological profile, which can affect outcomes in certain clinical settings. Cangrelor is an intravenous, direct-acting, potent P2Y12 inhibitor with rapid onset and offset of action, which has been recently approved for clinical use in patients undergoing PCI...
November 2016: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/27677505/optimizing-the-use-of-cangrelor-in-the-real-world
#9
Arman Qamar, Deepak L Bhatt
Thrombotic events such as myocardial infarction or stent thrombosis are the major cause of adverse outcomes in patients undergoing percutaneous coronary intervention (PCI). While current antiplatelet agents, anticoagulants, and PCI techniques have reduced the risk of thrombotic events in PCI-treated patients, a considerable hazard still remains. Cangrelor is an intravenous P2Y12 receptor antagonist that provides a rapid onset and maximal platelet inhibition, which is quickly reversible. In the large-scale CHAMPION PHOENIX trial, cangrelor was shown to reduce ischemic events significantly, including myocardial infarction and stent thrombosis, without increasing the risk of severe bleeding across the full spectrum of patients undergoing PCI, with substantial benefits in all patient subgroups examined...
September 27, 2016: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/27677394/new-directions-for-pharmacotherapy-in-the-treatment-of-acute-coronary-syndrome
#10
Piotr Adamski, Urszula Adamska, Małgorzata Ostrowska, Marek Koziński, Jacek Kubica
Acute coronary syndromes (ACS) are one of the leading causes of death worldwide. Several landmark trials, followed by a widespread introduction of new agents, have significantly improved ACS outcomes in recent years. However, despite the use of contemporary therapy, a substantial number of ACS patients continue to suffer from cardiovascular events. Areas covered: The aim of this review was to summarize available data on innovative drugs and pharmacological strategies that have potential to amend the current ACS therapy...
October 10, 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27659567/cangrelor-fixing-life-or-just-a-leak
#11
EDITORIAL
Mathieu Kerneis, Johanne Silvain, Gilles Montalescot
No abstract text is available yet for this article.
September 26, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27659566/efficacy-and-safety-of-cangrelor-in-preventing-periprocedural-complications-in-patients-with-stable-angina-and-acute%C3%A2-coronary-syndromes-undergoing-percutaneous-coronary-intervention-the-champion-phoenix-trial
#12
Jérémie Abtan, P Gabriel Steg, Gregg W Stone, Kenneth W Mahaffey, C Michael Gibson, Christian W Hamm, Matthew J Price, Freddy Abnousi, Jayne Prats, Efthymios N Deliargyris, Harvey D White, Robert A Harrington, Deepak L Bhatt
OBJECTIVES: The purpose of this study was to examine the safety and efficacy of cangrelor in patients with stable angina (SA) or acute coronary syndrome (ACS). BACKGROUND: The CHAMPION PHOENIX (A Clinical Trial Comparing Cangrelor to Clopidogrel Standard Therapy in Subjects Who Require Percutaneous Coronary Intervention) trial demonstrated that cangrelor significantly reduced periprocedural ischemic events in all-comer percutaneous coronary intervention with a modest increase in mild and moderate bleeding...
September 26, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27605392/studies-of-the-interaction-of-ticagrelor-with-the-p2y13-receptor-and-with-p2y13-dependent-pro-platelet-formation-by-human-megakaryocytes
#13
Anna Björquist, Christian A Di Buduo, Eti A Femia, Robert F Storey, Richard C Becker, Alessandra Balduini, Sven Nylander, Marco Cattaneo
Ticagrelor is an antagonist of the platelet P2Y12 receptor for ADP, approved for the prevention of thromboembolic events in patients with acute coronary syndrome. Previous studies showed that ticagrelor has no significant activity versus P1 receptors for adenosine and other known P2Y receptors, with the exception of P2Y13, which was not tested. The P2Y12 antagonist cangrelor has been shown to also inhibit P2Y13 and to decrease the P2Y13-regulated capacity of megakaryocytes to produce pro-platelets. We tested whether or not ticagrelor inhibits P2Y13 signalling and function...
November 30, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27580219/periprocedural-platelet-inhibition-with-cangrelor-in-p2y12-inhibitor-na%C3%A3-ve-patients-with-acute-coronary-syndromes-a-matched-control-pharmacodynamic-comparison-in-real-world-patients
#14
Michal Droppa, Pascal Spahn, Khalid Takhgiriev, Karin A L Müller, Ahmed Alboji, Andreas Straub, Dominik Rath, Young-Hoon Jeong, Meinrad Gawaz, Tobias Geisler
BACKGROUND: Effective inhibition of platelet aggregation during PCI in high risk patients with ACS is of utmost importance. The new intravenous short acting P2Y12-receptor inhibitor cangrelor is available for use in PCI-treated patients. We aimed to study platelet inhibition during treatment with cangrelor and transition phase with oral P2Y12-receptor inhibitors in patients with acute coronary syndromes (ACS). METHODS: Cangrelor was administered during PCI to 21 P2Y12-inhibitor naïve patients with ACS...
November 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27544384/a-new-role-for-the-p2y-like-gpr17-receptor-in-the-modulation-of-multipotency-of-oligodendrocyte-precursor-cells-in-vitro
#15
Marta Boccazzi, Davide Lecca, Davide Marangon, Fabio Guagnini, Maria P Abbracchio, Stefania Ceruti
Oligodendrocyte precursor cells (OPCs, also called NG2 cells) are scattered throughout brain parenchyma, where they function as a reservoir to replace lost or damaged oligodendrocytes, the myelin-forming cells. The hypothesis that, under some circumstances, OPCs can actually behave as multipotent cells, thus generating astrocytes and neurons as well, has arisen from some in vitro and in vivo evidence, but the molecular pathways controlling this alternative fate of OPCs are not fully understood. Their identification would open new opportunities for neuronal replace strategies, by fostering the intrinsic ability of the brain to regenerate...
August 20, 2016: Purinergic Signalling
https://www.readbyqxmd.com/read/27485140/implications-of-different-criteria-for-percutaneous-coronary-intervention-related-myocardial-infarction-on-study-results-of-three-large-phase-iii-clinical-trials-the-champion-experience
#16
Sergio Leonardi, Renato D Lopes, Ph Gabriel Steg, Freddy Abnousi, Alberto Menozzi, Jayne Prats, Stacey Mangum, Matthew Wilson, Meredith Todd, Gregg W Stone, C Michael Gibson, Christian W Hamm, Matthew J Price, Harvey D White, Robert A Harrington, Deepak L Bhatt, Kenneth W Mahaffey
AIMS: The purpose of this study was to test whether different results between Cangrelor versus standard therapy to acHieve optimal Management of Platelet InhibitiON (CHAMPION) PCI/PLATFORM and PHOENIX trials are due in part to different definitions of percutaneous coronary intervention (PCI)-related myocardial infarction (MI). METHODS AND RESULTS: In patients with acute coronary syndrome (ACS), the definition of MI was identical in CHAMPION PCI and PLATFORM and did not require an assessment of baseline cardiac biomarker status, while in PHOENIX specific MI criteria were associated with different patient presentations...
August 2, 2016: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/27482008/consistent-reduction-in-periprocedural-myocardial-infarction-with-cangrelor-as-assessed-by-multiple-definitions-findings-from-champion-phoenix-cangrelor-versus-standard-therapy-to-achieve-optimal-management-of-platelet-inhibition
#17
Matthew A Cavender, Deepak L Bhatt, Gregg W Stone, Harvey D White, Ph Gabriel Steg, C Michael Gibson, Christian W Hamm, Matthew J Price, Sergio Leonardi, Jayne Prats, Efthymios N Deliargyris, Kenneth W Mahaffey, Robert A Harrington
BACKGROUND: Cangrelor is an intravenous P2Y12 inhibitor approved to reduce periprocedural ischemic events in patients undergoing percutaneous coronary intervention not pretreated with a P2Y12 inhibitor. METHODS: A total of 11 145 patients were randomized to cangrelor or clopidogrel in the CHAMPION PHOENIX trial (Cangrelor versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition). We explored the effects of cangrelor on myocardial infarction (MI) using different definitions and performed sensitivity analyses on the primary end point of the trial...
September 6, 2016: Circulation
https://www.readbyqxmd.com/read/27366081/impact-of-selective-platelet-inhibition-in-reducing-cardiovascular-risk-role-of-vorapaxar
#18
REVIEW
Judy Wm Cheng
This article reviews the pharmacology, clinical efficacy, and safety of vorapaxar in reducing cardiovascular risk. Vorapaxar is a tricyclic himbacine-derived reversible inhibitor of platelet surface protease activator receptor-1, which prevents thrombin from activating platelets. Two Phase III clinical trials and multiple subanalyses from the two trials with vorapaxar have been published. In patients with recent acute coronary syndrome, vorapaxar, when added to standard therapy, did not reduce the composite cardiovascular end point...
2016: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/27362653/cangrelor-for-the-management-and-prevention-of-arterial-thrombosis
#19
Robert F Storey, Akanksha Sinha
INTRODUCTION: Despite advances in antiplatelet therapy, the optimum antithrombotic regimen during percutaneous coronary intervention (PCI) remains to be determined. Cangrelor is an intravenous, reversibly-binding platelet P2Y12 receptor antagonist with ultra-rapid onset and offset of action that is approved in Europe and United States for use in patients undergoing PCI. This article describes the background for the development of cangrelor, the biology, pharmacology and clinical evidence supporting its use, and its likely position in the future...
September 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27313282/variation-in-patient-profiles-and-outcomes-in-us-and-non-us-subgroups-of-the-cangrelor-versus-standard-therapy-to-achieve-optimal-management-of-platelet-inhibition-champion-phoenix-trial
#20
Muthiah Vaduganathan, Robert A Harrington, Gregg W Stone, Ph Gabriel Steg, C Michael Gibson, Christian W Hamm, Matthew J Price, Jayne Prats, Efthymios N Deliargyris, Kenneth W Mahaffey, Harvey D White, Deepak L Bhatt
BACKGROUND: The Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition (CHAMPION) PHOENIX trial demonstrated superiority of cangrelor in reducing ischemic events at 48 hours in patients undergoing percutaneous coronary intervention compared with clopidogrel. METHODS AND RESULTS: We analyzed all patients included in the modified intention-to-treat analysis in US (n=4097; 37.4%) and non-US subgroups (n=6845; 62.6%). The US cohort was older, had a higher burden of cardiovascular risk factors, and had more frequently undergone prior cardiovascular procedures...
June 2016: Circulation. Cardiovascular Interventions
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