Drug updated on 5/17/2024
Dosage Form | Injection (intravenous; 50 mg/ 10 mL) |
Drug Class | P2Y12 platelet inhibitors |
Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated as an adjunct to percutaneous coronary intervention (PCI) for reducing the risk of periprocedural myocardial infarction (MI), repeat coronary revascularization, and stent thrombosis (ST) in patients in who have not been treated with a P2Y12 platelet inhibitor and are not being given a glycoprotein IIb/IIIa inhibitor.
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Summary
- Cangrelor (Kengreal) is indicated as an adjunct to percutaneous coronary intervention for reducing the risk of periprocedural 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.
- Seven studies were reviewed, providing comprehensive information about Kengreal's safety and effectiveness compared to other drugs like clopidogrel, prasugrel, ticagrelor, particularly in the context of PCI.
- Compared to clopidogrel and other P2Y12 inhibitors such as prasugrel or ticagrelor, Kengreal significantly decreased the risk of composite adverse cardiovascular ischemic events. However, it was associated with higher incidence of major or any bleeding.
- In specific subgroups, such as patients with type 2 diabetes mellitus undergoing PCI or those requiring perioperative administration during surgery, Kengreal showed comparable efficacy but had increased risks related to mild GUSTO bleeding along with major & minor ACUITY bleeding.
- When used alongside endovascular therapy for stroke treatment, especially large-vessel occlusion strokes, Kengreal demonstrated a promising safety profile while also showing potential benefits beyond its current indications.
- Despite having significant advantages in reducing thrombotic events among patients undergoing PCI procedures, careful consideration should be taken due to its consistent association with increased bleeding risks, especially among vulnerable patient groups such as diabetics.
Product Monograph / Prescribing Information
Document Title | Year | Source |
---|---|---|
Kengreal (cangrelor) Prescribing Information. | 2023 | Chiesi USA, Inc., Cary, NC |
Systematic Reviews / Meta-Analyses
Clinical Practice Guidelines
Document Title | Year | Source |
---|---|---|
2021 ACC/AHA/SCAI guideline for coronary artery revascularization. | 2022 | Journal of the American College of Cardiology |
2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). | 2020 | European Heart Journal |